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Clinical trials

Superior efficacy of empagliflozin and finerenone combination therapy versus monotherapy in patients with CKD and T2DM

Nature Reviews Nephrology volume 21, page 523 (2025)Cite this article

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New data from the CONFIDENCE trial show that combination therapy with a sodium–glucose cotransporter 2 (SGLT2) inhibitor, empagliflozin, and the nonsteroidal mineralocorticoid receptor antagonist, finerenone, resulted in a significantly greater reduction in albuminuria than either treatment alone in patients with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). These results were presented at the 62nd European Renal Association Congress in Vienna.

Rajiv Agarwal and colleagues randomly assigned 818 patients with CKD and T2DM to combination therapy or monotherapy with empagliflozin or finerenone. All participants also received the maximum tolerated labelled dose of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker. The primary outcome was change in urinary albumin to creatinine ratio (UACR) from baseline to day 180.

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Original article

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  • Agarwal, R. et al. Impact of finerenone-induced albuminuria reduction on chronic kidney disease outcomes in type 2 diabetes: a mediation analysis. Ann. Intern. Med. 176, 1606–1616 (2023)

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  1. Nature Reviews Nephrology http://www.nature.com/nrneph

    Ellen F. Carney

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  1. Ellen F. Carney
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Correspondence to Ellen F. Carney.

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Carney, E.F. Superior efficacy of empagliflozin and finerenone combination therapy versus monotherapy in patients with CKD and T2DM. Nat Rev Nephrol 21, 523 (2025). https://doi.org/10.1038/s41581-025-00986-7

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  • DOI: https://doi.org/10.1038/s41581-025-00986-7

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