{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T04:41:24Z","timestamp":1792384884080,"version":"4.4.0"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Finerenone has emerged as a promising therapeutic agent for IgA nephropathy (IgAN). The role of finerenone in IgAN patients who have discontinued renin\u2010angiotensin system inhibitor (RASi) therapy remains poorly defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective, multicentre cohort study enrolled patients with primary IgAN who received finerenone and\/or RASi treatment. Participants were categorised into three groups: the finerenone plus RASi, finerenone (after RASi discontinuation) and RASi groups. All participants had a baseline estimated glomerular filtration rate (eGFR)\u2009\u2265\u200925\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      and urinary total protein (UTP)\u2009\u2265\u20090.5\u2009g\/day. The primary outcomes included the percentage change in UTP from baseline and the rate of significant response (defined as \u2265\u200950% reduction in UTP and &lt;\u200920% increase in serum creatinine).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Following 1:1:1 propensity score matching, a total of 258 patients were analysed, with 86 in each group. At 12\u2009months, UTP decreased by 32.24% in the finerenone group and 34.35% in the RASi group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.220). The finerenone plus RASi group achieved a significantly greater reduction of 54.43% compared with either monotherapy group (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Kaplan\u2013Meier analysis confirmed that the finerenone plus RASi group achieved superior significant response rates compared with either monotherapy group (both log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001). No significant difference was observed between the RASi and finerenone groups (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.856). Although the finerenone plus RASi group exhibited a numerically steeper total eGFR decline (\u22121.48 vs. \u22120.44 vs. \u22120.52\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      \/year) and a greater increase in the chronic eGFR slope (0.66 vs. 0.37 vs. 0.49\u2009mL\/min\/1.73\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      \/year), neither difference reached statistical significance compared with the finerenone or RASi groups. The incidence of adverse events was comparable across all three groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Finerenone achieved short\u2010term proteinuria reductions in RASi discontinued IgAN patients similar to those achieved with RASi monotherapy. Finerenone combined with RASi enhanced antiproteinuric efficacy while maintaining safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.71225","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T07:56:14Z","timestamp":1786953374000},"page":"10131-10141","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Finerenone for\n                    <scp>IgA<\/scp>\n                    Nephropathy After Renin\u2010Angiotensin System Inhibitors Discontinuation: A Multicentre Retrospective Cohort Study"],"prefix":"10.1111","volume":"28","author":[{"given":"Fang","family":"Zeng","sequence":"first","affiliation":[{"name":"Department of Nephrology The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University  Nanchang China"},{"name":"Department of Nephrology The Affiliated Ganzhou Hospital, Jiangxi Medical College, Nanchang University  Ganzhou 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Management Center The First Affiliated Hospital, Jiangxi Medical College, Nanchang University  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daijin","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Health Management Center Jiangxi Provincial People's Hospital  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6528-2370","authenticated-orcid":false,"given":"Xiaoli","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Nephrology The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University  Nanchang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjun","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Nephrology The First Affiliated Hospital of Gannan Medical University  Ganzhou 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