Do you plan to initiate combination therapy with an SGLT-2 inhibitor and finerenone, instead of an SGLT-2 inhibitor alone, when treating patients with proteinuric chronic kidney disease and type 2 diabetes in light of the CONFIDENCE trial findings?  

I would start one (typically the SGLT-2 inhibitor), then add finerenone potentially later. If both are started simultaneously and there is an AE, then both may have to be stopped. I prefer to see that one is tolerated, then start another.

No. I would go step by step and evaluate the response. First blood pressure control, then ACE/ARB, then SGLT-2, and finally finerenone. At each step, I would evaluate the effect on proteinuria, and if I achieve a significant reduction and the goal level, I would consider whether the next step is nec...

I don’t see anyone commenting on why the CONFIDENCE trial from NEJM earlier this month is not strong enough data to change our practice?