An Observational Study Called FIRST-2.0 to Learn More About the Use of the Study Treatment Finerenone Including How Safe it is and How Well it Works Under Real-world Conditions

NCT05703880 | Completed

• 1 other identifier: 22381
• Study Type: observational
• Target: 15,948
• Locations: 1 country
• Sites: 2

Brief Summary

This is an observational study, in which data from people in the United States (US) with chronic kidney disease (CKD) together with type 2 diabetes (T2D) are studied. The participants in this study are already receiving the study treatment finerenone as part of their regular care from their doctors. In observational studies, only observations are made without specified advice or interventions. CKD is a long-term progressive decrease in the kidneys' ability to work properly. In people with T2D, the body does not make enough of a hormone called insulin, or does not use insulin well enough. The resulting high blood sugar levels can cause damage to the kidneys. CKD often occurs together with T2D or as a consequence of T2D. Finerenone works by blocking certain proteins, called mineralocorticoid receptors. By doing this, it may reduce damage to kidneys, heart and blood vessels. Finerenone was recently approved in the US and is now available for doctors to prescribe to people with CKD together with T2D. Consequently, there is a need to collect more information about how finerenone is used, its safety and how well it works under real-world conditions. The main purpose of this study is to collect and describe the characteristics of people with CKD and T2D who are receiving finerenone treatment as prescribed by their doctors. To do this, the researchers will collect data on:

• general information of the participants such as age or gender
• any other disease or medical condition in the participants
• other medications used while taking finerenone. The researchers will also collect data on kidney function and possible heart problems to find out how well finerenone works. Additionally, medical problems possibly related to finerenone treatment will be collected to learn more about how safe finerenone is in real-world use. The data will come from US databases Optum Electronic Health Records (EHR) and OM1 Real-World Data Cloud (RWDC). They will cover the period from July 2021 to May 2023. Only already available data is collected and studied. There are no required visits or tests in this study.

Conditions

Chronic Kidney Disease; Type 2 Diabetes Mellitus

Outcome Measures

Primary Outcomes (3)

• Descriptive summary of characteristics of patients who initiate finerenone and have CKD and T2D in the US.

  Up to 365 days

• Descriptive summary of comorbidities of patients who initiate finerenone and have CKD and T2D in the US.

  Up to 365 days

• Descriptive summary of comedications of patients who initiate finerenone and have CKD and T2D in the US.

  Up to 180 days

Secondary Outcomes (11)

• Incidence rate of composite renal outcomes

  Up to 18 months

• Incidence rate of composite cardiovascular outcomes

  Up to 18 months

• Number of patients who initiate finerenone using a 10 mg dose and number of patients who have up-titrated to a 20 mg dose by 1, 3, 6, and 12 months, respectively.

  Up to 18 months

• Number of patients who initiate finerenone using a 20 mg dose and number of patients who have down-titrated to a 10 mg dose by 1, 3, 6, and 12 months, respectively

  Up to 18 months

• Incidence rate of hyperkalemia

  Up to 18 months

Study Arms (1)

Finerenone (Kerendia, BAY948862)

Adults with CKD and T2D from the USA who initiate finerenone.

Drug: Finerenone (Kerendia, BAY948862)

Interventions

Finerenone (Kerendia, BAY948862) DRUG

Retrospective cohort analysis using United States Optum EHR data and OM1 RWDC databases.

Finerenone (Kerendia, BAY948862)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Persons initiating finerenone who have CKD and T2D will be included based on combinations of diagnosis codes of CKD and T2D, respectively, prescriptions and laboratory values (e.g., eGFR values or UACR measurements) indicating CKD and T2D.

You may qualify if:

• Minimum of 12 months continuous enrolment in the EHR databases with medical and pharmacy coverage measured as continuously receiving medical care from health providers contributing to the EHR system.
• No recorded prescription of finerenone prior to the index date.
• Age 18 years or older as of the index date.
• T2D diagnosis at any point before (and including) the index date using the same algorithms applicable to the specific data source as in previous studies of the FIRST program.
• CKD stages 2-4 related to eligibility will be defined according to the presence of the following criteria at any point before (and including) the index date:
• A diagnosis code indicating CKD stage 2, 3, 4, or stage unspecified OR
• Two Urinary Albumin-to-Creatinine Ratio (ACR) test results ≥ 30 mg/g separated by at least 90 days and no more than 540 days OR
• Two different eGFR test results ≥ 15 mL/min/1.73 m\*2 AND \< 60 mL/min/1.73 m\*2 separated by at least 90 days and no more than 540 days.

You may not qualify if:

• Type 1 diabetes identified by appropriate algorithms in the data source
• Kidney cancer on or before the index date
• Kidney failure defined as:
• Two different eGFR test results \< 15 mL/min/1.73 m\*2 separated by at least 90 days and no more than 540 days
• Dependence on dialysis (at least 3 sessions over at least 90 days during the baseline period)
• A diagnosis code indicating kidney failure or CKD stage 5 (International Classification of Diseases, 10th Revision)
• Kidney transplant

Sponsors & Collaborators

• Bayer: lead

Study Sites (2)

OM1 Real-World Data Cloud (RWDC)

Boston, Massachusetts, 02116, United States

Location

Optum electronic health records (EHR) database

Eden Prairie, Minnesota, 55344, United States

Location

Related Publications (1)

• Vizcaya D, Kovesdy CP, Reyes A, Pessina E, Pujol P, James G, Oberprieler NG. Characteristics of patients with chronic kidney disease and Type 2 diabetes initiating finerenone in the USA: a multi-database, cross-sectional study. J Comp Eff Res. 2023 Aug;12(8):e230076. doi: 10.57264/cer-2023-0076. Epub 2023 Jun 30.

  PMID: 37387399 DERIVED

Related Links

• Click here to find information for studies related to Bayer products. To find this study enter the ClinicalTrials.gov identifier (NCT) number or Bayer Study Identifier (ID) in the search field.

MeSH Terms

Conditions

Renal Insufficiency, Chronic; Diabetes Mellitus, Type 2

Interventions

finerenone

Condition Hierarchy (Ancestors)

Renal Insufficiency; Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 20, 2023
• First Posted: January 30, 2023
• Study Start: June 1, 2023
• Primary Completion: October 1, 2024
• Study Completion: October 1, 2024
• Last Updated: October 18, 2024

Record last verified: 2024-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (2)