Supplementary Material for: Cardiorenal Outcomes With Finerenone in Asian Patients With Chronic Kidney Disease and Type 2 Diabetes: A FIDELIO-DKD Post Hoc Analysis

Introduction In FIDELIO-DKD, finerenone significantly improved cardiorenal outcomes in patients with chronic kidney disease and type 2 diabetes. This post hoc analysis explores finerenone in patients from the Asian region. Methods In FIDELIO-DKD, 5674 patients with type 2 diabetes and urine albumin-to-creatinine ratio ≥30–<300 mg/g and estimated glomerular filtration rate (eGFR) ≥25–<60 mL/min/1.73 m2, or urine albumin-to-creatinine ratio ≥300–≤5000 mg/g and eGFR ≥25–<75 mL/min/1.73 m2, treated with optimized renin–angiotensin system blockade, were randomized 1:1 to finerenone or placebo. Efficacy outcomes included a primary kidney composite (time to kidney failure, sustained decrease of ≥40% in eGFR from baseline, and death from renal causes) and secondary cardiovascular (time to cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, or hospitalization for heart failure) and kidney (time to kidney failure, sustained decrease of ≥57% in eGFR from baseline, and death from renal causes) composites. Results Of 1,327 patients in the Asian subgroup, 665 received finerenone. Finerenone reduced the ≥40% and ≥57% eGFR kidney and cardiovascular composite outcomes versus placebo in the Asian subgroup (hazard ratio [HR]: 0.70; 95% confidence interval [CI]: 0.56–0.87, HR: 0.73; 95% CI: 0.55–0.97, and HR: 0.85; 95% CI: 0.59–1.21, respectively), with no apparent differences versus patients from the rest of the world (HR: 0.88; 95% CI: 0.77–1.02; P interaction 0.09, HR: 0.78; 95% CI: 0.64–0.95 P interaction 0.71, and HR: 0.86; 95% CI: 0.74–1.00; P interaction 0.95, respectively). The safety profile of finerenone was similar across subgroups. Discussion/Conclusion Finerenone produces similar cardiorenal benefits in Asian and non-Asian patients.