{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:12:07Z","timestamp":1790957527145,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,2,26]],"date-time":"2023-02-26T00:00:00Z","timestamp":1677369600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the effect of finerenone by baseline HbA1c, HbA1c variability, diabetes duration and baseline insulin use on cardiorenal outcomes and diabetes progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Composite efficacy outcomes included cardiovascular (cardiovascular death, non\u2010fatal myocardial infarction, non\u2010fatal stroke or hospitalization for heart failure), kidney (kidney failure, sustained \u2265\u200957% estimated glomerular filtration rate decline or renal death) and diabetes progression (new insulin initiation, increase in antidiabetic medication, 1.0% increase in HbA1c from baseline, new diabetic ketoacidosis diagnosis or uncontrolled diabetes).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In 13\u2009026 participants, risk reductions in the cardiovascular and kidney composite outcomes with finerenone versus placebo were consistent across HbA1c quartiles (\n                      <jats:italic>P<\/jats:italic>\n                      interaction .52 and .09, respectively), HbA1c variability (\n                      <jats:italic>P<\/jats:italic>\n                      interaction .48 and .10), diabetes duration (\n                      <jats:italic>P<\/jats:italic>\n                      interaction .12 and .75) and insulin use (\n                      <jats:italic>P<\/jats:italic>\n                      interaction .16 and .52). HbA1c variability in the first year of treatment was associated with a higher risk of cardiovascular and kidney events (hazard ratio [HR] 1.20; 95% confidence interval [CI] 1.07\u20101.35;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u2009.0016 and HR 1.36; 95% CI 1.21\u20101.52;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u2009.0001, respectively). There was no effect on diabetes progression with finerenone or placebo (HR 1.00; 95% CI 0.95\u20101.04). Finerenone was well\u2010tolerated across subgroups; discontinuation and hospitalization because of hyperkalaemia were low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Finerenone efficacy was not modified by baseline HbA1c, HbA1c variability, diabetes duration or baseline insulin use. Greater HbA1c variability appeared to be associated with an increased risk of cardiorenal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.14999","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T07:33:37Z","timestamp":1675236817000},"page":"1512-1522","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Effects of finerenone in people with chronic kidney disease and type 2 diabetes are independent of\n                    <scp>HbA1c<\/scp>\n                    at baseline,\n                    <scp>HbA1c<\/scp>\n                    variability, diabetes duration and insulin use at baseline"],"prefix":"10.1111","volume":"25","author":[{"given":"Janet B.","family":"McGill","sequence":"first","affiliation":[{"name":"Division of Endocrinology, Metabolism and Lipid Research Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8355-7100","authenticated-orcid":false,"given":"Rajiv","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Richard L. Roudebush VA Medical Center and Indiana University  Indianapolis Indiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan D.","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK)  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1183-1267","authenticated-orcid":false,"given":"George L.","family":"Bakris","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Chicago Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, School of Medicine National and Kapodistrian University of Athens, Attikon University Hospital  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertram","family":"Pitt","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Michigan School of Medicine  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis M.","family":"Ruilope","sequence":"additional","affiliation":[{"name":"Cardiorenal Translational Laboratory and Hypertension Unit Institute of Research imas12  Madrid Spain"},{"name":"CIBER\u2010CV, Hospital Universitario 12 de Octubre  Madrid Spain"},{"name":"Faculty of Sport Sciences European University of Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1407-9023","authenticated-orcid":false,"given":"Andreas L.","family":"Birkenfeld","sequence":"additional","affiliation":[{"name":"Department of Diabetology, Endocrinology and Nephrology University Clinic  T\u00fcbingen Germany"},{"name":"Institute for Diabetes Research and Metabolic Diseases of Helmholtz Center Munich, German Center of Diabetes Research (DZD e.V.) 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