Impact of Simultaneous Initiation of Finerenone and Empagliflozin on Albuminuria Irrespective of Baseline HbA1c Levels: A Participant-Level Exploratory Analysis of the Randomised CONFIDENCE Trial.
Diabetes Obes MetabJun 15, 2026 (epub)
Janet B McGill, Jennifer B Green, Hiddo J L Heerspink et al.
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In 30 seconds
This exploratory analysis of the randomized CONFIDENCE trial assessed the impact of simultaneous initiation of finerenone and empagliflozin on albuminuria in adults with type 2 diabetes. The study found that combination therapy significantly reduced urinary albumin-to-creatinine ratio (UACR) at Day 180 across all baseline HbA1c quartiles, with a mean reduction of -53% to -63% compared to monotherapy.
Key findings
- Combination therapy reduced UACR by -53% to -63% across HbA1c quartiles at Day 180.
- HbA1c decreased by -0.1% with combination therapy and empagliflozin, with no change from finerenone.
- The greatest HbA1c reduction occurred in participants with the highest baseline levels (Quartile 4).
Why it matters
The findings suggest that initiating finerenone and an SGLT2i together can effectively reduce albuminuria in patients with type 2 diabetes, regardless of their baseline HbA1c levels, which may inform treatment strategies aimed at renal protection.