Do you consider the albuminuria reduction seen in FINE-ONE sufficient to start finerenone without hard kidney outcome data in a patient with CKD and type 1 diabetes?

The albuminuria reduction was tested as a “bridging biomarker” which means that if the reduction in albuminuria was similar to the larger studies in type 2 diabetes, then both the safety an efficacy of finerenone in reducing hard renal and cardiovascular outcomes is expected without further testing....

I would prefer for all these agents to see significant reduction in proteinuria as well as eGFR stablization.

Yes, it is sufficient, based on detailed approvals by regulators, including the FDA, which has approved finerenone for T1D-CKD. UACR lowering by this magnitude is so closely associated with long-term benefits in patients with established CKD+albuminuria that UACR can act as a “bridging biomarker” in...

The FINE-ONE trial showed that 6 months of therapy with finerenone in patients with T1DM and albuminuria decreased albumin excretion compared to placebo. On the basis of this, the FDA approved finerenone in September 2026 as the first new therapy for CKD in T1DM in 30 years. There has been much hoop...