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June 7, 2026Diabetes

1393-P: Comparative Efficacy of Use of Combined Finerenone and Conventional Dose Angiotensin II Receptor Blockers vs. High-Dose ARB on Renal Markers in T2DM Patients with Stage 1–3 Diabetic Nephropathy Receiving SGLT2i

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Why the study?

Does conventional dose ARB plus finerenone improve cardio-renal markers compared to high-dose ARB in T2DM patients with stage 1-3 diabetic nephropathy receiving SGLT2 inhibitors?

Population

112 T2DM patients with stage 1-3 diabetic nephropathy, aged <75 years, receiving SGLT2i, ARBs, on regular…

Comparison

Conventional dose ARB plus finerenone vs High dose ARB alone

Design

Cohort

Follow-up

6 months

Authors

VGVISHAL GUPTA

Discussion

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Overview

Up-titration of ARB is as effective as adding finerenone to conventional dose ARB for improving renal markers over 6 months in T2DM patients with stage 1-3 diabetic nephropathy on SGLT2 inhibitors.

Key Points

  • The aim was to evaluate the efficacy of combined finerenone with conventional dose ARBs compared to high-dose ARBs on cardio-renal markers in T2DM patients with diabetic nephropathy.
  • 112 T2DM patients aged <75 years with stage 1-3 diabetic nephropathy were analyzed.
  • Patients receiving SGLT2 inhibitors were divided into two groups: CDARB + Fi and HDARB, with propensity score matching for baseline characteristics.
  • Data analysis was performed using SPSS version 27 with various statistical tests.
  • No significant changes in cardio-renal markers over 6 months between the two groups.
  • Both groups demonstrated similar reductions in UACR, TC, and LDL at 6 months.
  • Systolic blood pressure was significantly lower in the combined therapy group at baseline.

Structured PICO

Does conventional dose ARB plus finerenone improve cardio-renal markers compared to high-dose ARB in T2DM patients with stage 1-3 diabetic nephropathy receiving SGLT2 inhibitors?

P
Population
112 T2DM patients with stage 1-3 diabetic nephropathy, aged <75 years, receiving SGLT2i (dapagliflozin), ARBs, on regular follow-up, plus other standard glucose, lipid & BP lowering therapies. Exclusions: any revascularization, IHD, hospitalization in last 1 yr, eGFR <45, K+ >5.5.
I
Intervention
Conventional dose ARB (valsartan ≤160mg/d or telmisartan ≤80mg/d) plus finerenone (Group A, n=62)
C
Comparator
High dose ARB alone (valsartan >160mg/d or telmisartan >80mg/d) (Group B, n=50)
O
Outcome
Cardio-renal markers (Cr, eGFR, UACR, SBP/DBP, BMI, Lipid profile, hs-CRP) analyzed 2-3 monthly for 6 monthssurrogate

Up-titration of ARB is as effective as adding finerenone to conventional dose ARB for improving renal markers over 6 months in T2DM patients with stage 1-3 diabetic nephropathy on SGLT2 inhibitors.

Cite This Study

VISHAL GUPTA (2026) studied this question.

synapsesocial.com/papers/6a250c7d7def13d035e1c96fhttps://doi.org/10.2337/db26-1393-p
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Comparative Evaluation of ARB Monotherapy and SGLT2/ACE Inhibitor Combination Therapy in the Renal Function of Diabetes Mellitus Patients: A Retrospective, Longitudinal Cohort Study2025 · 2 citations
  2. 2Evaluating the Efficacy of Finerenone in Reducing Proteinuria in Diabetic Nephropathy Patients Receiving Maximum Tolerable Doses of Dapagliflozin and Telmisartan2025
  3. 3Finerenone in diabetic kidney disease: Findings from a single-center retrospective observational study2026
  4. 4Stress hyperglycemia ratio (SHR) and triglyceride-glucose index (TYG) associated with renal response to finerenone in diabetic kidney disease: a retrospective cohort study2026
  5. 5Renoprotective Effects of RAAS Inhibitors in Patients with Diabetic Nephropathy: A Comprehensive Meta-Analysis of Randomized Controlled Trials2025 · 1 citations