(Glasgow, Scotland) Finerenone significantly slowed kidney function decline and reduced the risk of cardiovascular-kidney outcomes in adults with non-diabetic chronic kidney disease (CKD), according to late-breaking results from the Phase III FIND-CKD trial presented at the 63rd ERA Congress and published in the New England Journal of Medicine.1
CKD affects approximately 850 million people worldwide.2 While diabetes is a major cause of CKD, many patients still develop the condition in its absence. Despite currently available therapies, these individuals remain at risk of progressive kidney function decline, kidney failure and cardiovascular complications.3,4
FIND-CKD is the largest Phase III study to date focused on non-diabetic CKD. The trial enrolled more than 1,500 patients with a range of underlying causes of kidney disease, including hypertension-associated kidney disease and glomerular diseases. Participants were randomised to receive finerenone or placebo in addition to standard of care, including maximally tolerated renin-angiotensin system (RAS)-blocking therapy.
The study met its primary endpoint, showing that finerenone significantly slowed the annual rate of decline in estimated glomerular filtration rate (eGFR), a standard measure of kidney function. Compared with placebo, finerenone reduced the rate of kidney function decline by 0.7 mL/min/1.73 m²/year (95% CI 0.3 to 1.1; p<0.001).
Finerenone also significantly reduced the risk of the key secondary composite cardiovascular-kidney outcome by 23% compared with placebo (HR 0.77; 95% CI 0.60 to 0.99; p=0.043). This outcome included kidney failure, sustained ≥57% decline in eGFR, hospitalisation for heart failure or cardiovascular death.
Lead author Professor Hiddo Lambers Heerspink, University Medical Center Groningen, the Netherlands, and Co-Chair of the study's Executive Committee, said: "FIND-CKD is a large, rigorously conducted study in non-diabetic CKD across multiple etiologies. The results show that finerenone significantly preserved kidney function and reduced the risk of cardiovascular-kidney outcomes with a consistent effect across prespecified subgroups, supporting a broad applicability in these patients."
Finerenone was also well tolerated, with a safety profile consistent with previous studies and no new safety signals identified. Hyperkalaemia-related adverse events occurred more frequently with finerenone than placebo, but few events led to treatment discontinuation or hospitalisation. Acute kidney injury occurred at similar rates in both groups.
