Safety and Synergy of Finerenone and Empagliflozin in Lowering Blood Pressure.
Rajiv Agarwal, Ricardo Correa-Rotter, Sankar D Navaneethan et al.
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In 30 seconds
This randomized controlled trial analyzed the effects of finerenone and empagliflozin combination therapy on systolic blood pressure (SBP) in 800 participants with chronic kidney disease and type 2 diabetes. The combination therapy significantly increased the odds of achieving a ≥10 mm Hg SBP reduction compared to monotherapy, with an odds ratio of 1.83 (P = 0.004) for finerenone and 1.45 (P = 0.07) for empagliflozin.
Key findings
- Combination therapy increased SBP response odds versus finerenone (odds ratio, 1.83; P = 0.004).
- SBP reduction was significant in participants with baseline SBP ≥130 mm Hg (P <0.0001).
- The strongest predictor of SBP response was baseline SBP (odds ratio, 2.04 per 10 mm Hg increase; P <0.0001).
- SBP changes mediated less than 10% of the total urinary albumin-to-creatinine ratio reduction.
Why it matters
Understanding the efficacy of combination therapy in managing blood pressure is crucial for clinicians treating patients with chronic kidney disease and type 2 diabetes, as it may enhance patient outcomes and inform treatment strategies.
What to keep in mind
This secondary analysis relied on clinic blood pressure measurements, which may not reflect true ambulatory blood pressure changes.