← Back to papers

Simultaneous initiation of finerenone and empagliflozin across the spectrum of kidney risk in the CONFIDENCE trial

★ ★ ★ ★ ☆

Paper Summary

Paperzilla title
Double Diabetes Meds Combo Better Than Going Solo for Kidney Trouble

A study of patients with type 2 diabetes and chronic kidney disease found that taking finerenone and empagliflozin together worked better than either drug alone for reducing a key marker of kidney damage (UACR). The benefits were seen across a range of kidney disease severity, but the study only lasted six months, so longer-term outcomes are unknown. The study was sponsored by the company that makes finerenone, and multiple authors reported ties to pharmaceutical companies.

Explain Like I'm Five

Combining two diabetes medications (finerenone and empagliflozin) seems to work better than using either one alone, no matter how severe the patient's kidney issues are. This could lead to new treatments for people with diabetic kidney disease.

Possible Conflicts of Interest

The study was funded by Bayer AG, the manufacturer of finerenone. Several authors disclosed financial ties to pharmaceutical companies, including Bayer, that manufacture diabetes and kidney medications. While the authors state that they designed the trial and analyzed the data independently, the funding source and industry ties represent a potential conflict of interest.

Identified Limitations

Short follow-up duration
The study only lasted 6 months, which is a short time frame for kidney disease progression.
Uneven distribution of KDIGO risk categories
While the trial included patients across a range of kidney function, the majority had high or very high risk of kidney failure, making it harder to generalize the findings to everyone with diabetic kidney disease.
Stringent inclusion/exclusion criteria
The study used very specific criteria for enrolling patients, which might not reflect real-world practice.

Rating Explanation

This is a well-designed study with a large sample size that addresses an important clinical question. The findings are promising for the treatment of diabetic kidney disease. However, the short follow-up duration and the specific patient population limit the generalizability of the findings slightly, hence the rating of 4 instead of 5.

Good to know

This is the Starter analysis. Paperzilla Pro fact-checks every citation, researches author backgrounds and funding sources, and uses advanced AI reasoning for more thorough insights.

Explore Pro →

Topic Hierarchy

Domain: Health Sciences
Field: Medicine
Subfield: Nephrology

File Information

Original Title: Simultaneous initiation of finerenone and empagliflozin across the spectrum of kidney risk in the CONFIDENCE trial
Uploaded: September 03, 2025 at 05:11 PM
Privacy: Public