Supplementary Material for: Change in Urine Albumin-Creatinine Ratio and Occurrence of Hyperkalemia in Patients Initiating Finerenone in the United States: A Cohort Study from the FOUNTAIN platform

Introduction. In 2021, finerenone – a novel, selective non-steroidal mineralocorticoid receptor antagonist – was approved in the US to treat adults with CKD and T2D This study aimed to describe characteristics and short-term outcomes of patients prescribed finerenone since regulatory approval.
Methods. This was a retrospective cohort study using claims and electronic health records data from the OM1 Real-World Data Cloud™. A total of 15,948 US adults with a previous diagnosis of chronic kidney disease (CKD) and type 2 diabetes who initiated
10mg or 20mg finerenone between July 2021 and August 2023 were included. Dosing was evaluated at baseline and over up to 12-months’ follow-up. Change from baseline in urine albumin-to-creatinine ratio (UACR) was evaluated at 4 and 12 months (among 913 and 443 patients, respectively, with available repeat UACR values). Hyperkalemia occurrence was determined at 12 months and over total follow-up.
Results. Median follow-up was 7.2 months. Mean age was 70.3 years; 44.1% were female. At baseline (-365; 0 days) 70% had CKD stage 3; for patients with UACR measurements 80.8% had moderate/severe albuminuria (≥30mg/g). Median UACR was 203mg/g. Co-medication use was: ACE inhibitors/ARBs (51%), SGLT2is (38%), and GLP-1 RAs (26%). 86% of patients initiated 10mg finerenone, and among 2212 patients still under observation at 12 months, 70% were on 10mg. For finerenone initiators with available UACR data, UACR was reduced by 33% at 4 months and 38% at 12 months. Hyperkalemia occurred in 1.2% of the cohort by 12 months (incidence 2.0 per 100 person-years).
Conclusion. Patients who initiated finerenone had a notable reduction in median UACR at 4 months, sustained at 12 months; hyperkalemia occurrence appeared to be low. These initial findings from US clinical practice should be complemented by results from other real-world cohorts of patients started on finerenone.