First interim results from FINE-REAL: a prospective, non-interventional, phase 4 study providing insights into the use and safety of finerenone in a routine clinical settingFirst Interim Results From Fine-Real: A Prospective, Non-interventional, Phase 4 Study Providing Insights Into the Use and Safety of Finerenone in a Routine Clinical Setting

Authors

Susanne B Nicholas
Ricardo Correa-Rotter
Nihar R Desai
Lixin Guo
Sankar D Navaneethan
Kevin M Pantalone
Christoph Wanner
Stefanie Hamacher
Samuel T Fatoba
Andrea Horvat-Broecker
Antonio Garreta-Rufas
Alain Gay
Martin Merz
David C Wheeler

Publication Date

11-1-2024

Journal

Journal of Nephrology

DOI

10.1007/s40620-024-02070-y

PMID

39340711

PMCID

PMC11649709

PubMedCentral® Posted Date

9-28-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Humans, Male, Female, Prospective Studies, Mineralocorticoid Receptor Antagonists, Aged, Middle Aged, Naphthyridines, Renal Insufficiency, Chronic, Diabetes Mellitus, Type 2, Hyperkalemia, Treatment Outcome, Diabetic Nephropathies

Abstract

Background: Finerenone, a selective non-steroidal mineralocorticoid receptor antagonist, improves kidney and cardiovascular outcomes in patients with chronic kidney disease (CKD) associated with type 2 diabetes (T2D). The FINE-REAL study (NCT05348733) aims to evaluate the characteristics and treatment patterns of participants treated with finerenone in clinical practice.

Methods: FINE-REAL is a prospective, single-arm, non-interventional study of patients initiated on finerenone as part of their routine care in accordance with country-approved labels. The study, initiated in June 2022, is expected to be completed by January 2028. The cutoff for this pre-specified interim analysis was June 13, 2023.

Results: Participants were recruited across nephrology, endocrinology, cardiology, and primary care settings. Of 556 participants enrolled in the study by the cut-off date, 504 were included in this analysis (median follow-up duration of 7 months [finerenone treatment initiation to last recorded observation]). At baseline, 76.1% of participants were in the high or very high (KDIGO) CKD risk categories. Angiotensin converting enzyme inhibitors/angiotensin receptor blockers and sodium-glucose cotransporter 2 inhibitors were prescribed to 71.8% and 46.6% of participants, respectively. Based on prescribing information, 87.9% and 12.1% of participants initiated finerenone at doses of 10 and 20 mg, respectively. Finerenone treatment was uninterrupted in 92.3% of participants after 7 months' median follow-up. Treatment-emergent adverse events occurred in 110 (21.8%) participants. Hyperkalemia occurred in 25 (5.0%) participants, with no cases leading to death, dialysis, or hospitalization.

Conclusion: At this interim analysis, finerenone was initiated in patients with CKD and T2D across various clinical practices participating in the study. Treatment discontinuation and hyperkalemia occurred infrequently.