How do you sequence finerenone and a GLP-1 receptor agonist after maximizing ACEi or ARB therapy in a patient with CKD, type 1 diabetes, obesity, and persistent albuminuria?
After maximizing ACE inhibitor or ARB therapy in a patient with CKD, type 1 diabetes, obesity, and persistent albuminuria, how do you sequence finerenone and a GLP-1 receptor agonist?
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GLP1-RA first, generally, then finerenone.
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T1DM patients with obesity have been shown to have higher rates of renal disease (Tentolouris et al., PMID 41721160). Liraglutide, semaglutide, and tirzepatide have been shown to have efficacy for weight loss in T1DM. A trial is currently underway to look at semaglutide and renal outcomes in T1DM. A...
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What we know from studies in type 2 diabetes is that finerenone retains efficacy in people taking GLP1 receptor agonists. There is no drug-drug interaction between these agents, so the combination is not restricted in any way. Unlike the initiation of finerenone and an SGLT2i simultaneously, which w...
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