These video briefs feature expert commentary on the latest clinical data presented atERA 2025 and highlight finerenone’s evolving role in the care of patients with the cardio-kidney-metabolic syndrome. Specialists discuss new findings from the CONFIDENCE trialand FINEARTS-HF trial, including the efficacy and safety of combining finerenone with SGLT2 inhibitors, finerenone’s impact on eGFR slope across albuminuria levels, and the prognostic significance of albuminuria reduction. The series delves into the mechanistic rationale, therapeutic implications, and real-world potential of nonsteroidal MRAs in managing patients with chronic kidney disease, type 2 diabetes, and heart failure. Viewers will gain practical insights on integrating these data into their clinical practice to improve patient outcomes.
The CONFIDENCE Trial: Data Insights
Welcome to DataPulse from ERA 2025. This activity, titled “The CONFIDENCE Trial: Data Insights” is provided by Medcon International.
Dr. Heerspink:
Hello, everyone. This is Hiddo Heerspink, affiliated with the University Medical Center Groningen in the Netherlands. I'm here at the European Renal Association meeting in Vienna, where we presented the results of the CONFIDENCE trial.
The CONFIDENCE trial tested the combined use of an SGLT2 inhibitor, empagliflozin, and a mineralocorticoid receptor antagonist, finerenone, in patients with type 2 diabetes and chronic kidney disease. We know already that SGLT2 inhibitors and finerenone protect the kidney. We don't know whether combined use of finerenone with an SGLT2 inhibitor can augment kidney protection and can also be safely initiated.
Therefore, we designed the CONFIDENCE trial, an active-controlled, randomized, clinical trial in patients with type 2 diabetes and chronic kidney disease who were randomized to empagliflozin, finerenone, and their combination. These patients were followed for 180 days, and we assessed the change in albuminuria as the primary endpoint.
At the end of the 180-day treatment period, we saw that empagliflozin and finerenone reduced albuminuria by about 30%. The combination reduced albuminuria by 53%, a significant larger reduction compared to either empagliflozin or finerenone.
The initiation of combined treatment was also safe. Hyperkalemia was reported by investigators in 30% of patients assigned to finerenone. Hyperkalemia was reported in 9% of patients who were assigned to combination treatment, and about 3% of patients who were randomized to empagliflozin. Orthostatic hypotension, acute kidney injury were rare adverse events.
So the trial demonstrated that combined initiation causes a significant reduction and clinically meaningful reduction in albuminuria of 53%, which should translate into long-term kidney protection. The combined initiation of finerenone and empagliflozin is also safe. So these results demonstrate now that you can initiate a combined use of empagliflozin and finerenone and that you don't have to necessarily sequence the 2 drugs.
If you are interested in the results of this trial, I recommend to read the publication, and the results are published in The New England Journal of Medicine.
Thank you very much for listening. This was Hiddo Heerspink from the European Renal Association meeting in Vienna.
Thank you for listening to this DataPulse from ERA 2025. This activity is provided by Medcon International Thank you for listening.
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Overview
Provider(s)/Educational Partner(s)
Today’s healthcare environment is constantly evolving and advances of medical science occur at an accelerating pace. CME/CE plays an important role in the clinical environment and is an essential element of physician training, learning, and improvement, thereby importantly contributing to optimal patient care. Since 2000, MEDCON’s mission is to deliver high quality within the world of medical education by creating forums like PACE-CME, organizing live meetings, and providing online education. We aim to stimulate the review, exchange, and assimilation of key scientific findings to improve patients’ health, to raise awareness of new science underlying various disease states, and to accelerate the translation of this information into clinical practice.
Commercial Support
This activity is supported by an independent educational grant from Bayer AG.
Overview
These video briefs feature expert commentary on the latest clinical data presented atERA 2025 and highlight finerenone’s evolving role in the care of patients with the cardio-kidney-metabolic syndrome. Specialists discuss new findings from the CONFIDENCE trialand FINEARTS-HF trial, including the efficacy and safety of combining finerenone with SGLT2 inhibitors, finerenone’s impact on eGFR slope across albuminuria levels, and the prognostic significance of albuminuria reduction. The series delves into the mechanistic rationale, therapeutic implications, and real-world potential of nonsteroidal MRAs in managing patients with chronic kidney disease, type 2 diabetes, and heart failure. Viewers will gain practical insights on integrating these data into their clinical practice to improve patient outcomes.
Provider(s)/Educational Partner(s)
Today’s healthcare environment is constantly evolving and advances of medical science occur at an accelerating pace. CME/CE plays an important role in the clinical environment and is an essential element of physician training, learning, and improvement, thereby importantly contributing to optimal patient care. Since 2000, MEDCON’s mission is to deliver high quality within the world of medical education by creating forums like PACE-CME, organizing live meetings, and providing online education. We aim to stimulate the review, exchange, and assimilation of key scientific findings to improve patients’ health, to raise awareness of new science underlying various disease states, and to accelerate the translation of this information into clinical practice.
Commercial Support
This activity is supported by an independent educational grant from Bayer AG.
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