Sexual dimorphism and age effects in CKD and type 2 diabetes in the CONFIDENCE trial.
Rajiv Agarwal, Jennifer B Green, Hiddo J L Heerspink et al.
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In 30 seconds
This analysis of the randomized CONFIDENCE trial examined age- and sex-related differences in urinary albumin-to-creatinine ratio (UACR) changes among people with type 2 diabetes and chronic kidney disease receiving empagliflozin, finerenone, or both. Older age and female sex were associated with greater UACR reductions at Day 180. For each 10-year increase in age, the incremental UACR change was -10.2% (95% CI: -15.5, -4.6); women had an 18.6% (95% CI: 6.3, 29.2) greater reduction than men. These associations did not modify the combination-therapy effect, and safety outcomes were consistent across demographic groups.
Key findings
- Each 10-year increase in age was associated with an incremental UACR change of -10.2% (95% CI: -15.5, -4.6) at Day 180.
- Women had an 18.6% (95% CI: 6.3, 29.2) greater UACR reduction at Day 180 than men.
- Age and sex did not significantly interact with the combination-therapy effect (P-interaction = 0.28 and P-interaction = 0.46, respectively).
- Safety outcomes were consistent across age and sex groups.
Why it matters
The findings indicate that UACR response varies with age and sex in this trial population, while the relative effect of combining finerenone and empagliflozin was not detectably modified by either characteristic. This helps contextualize albuminuria changes across demographic groups, but UACR is the reported outcome and the results do not establish differences in longer-term clinical outcomes.
What to keep in mind
The analysis reports UACR change rather than longer-term clinical outcomes; the abstract does not provide subgroup sample sizes.