Simultaneous initiation of finerenone and empagliflozin across the spectrum of kidney risk in the CONFIDENCE trial
Overview
Paper Summary
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
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.
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