这项研究的目的是评估在患有心血管和慢性肾脏疾病的2型糖尿病(T2DM)患者中使用finetenone治疗的安全性和有效性。这项荟萃分析评估了finetenone治疗糖尿病肾病(DKD)的有效性和安全性。全面搜索PubMed,Embase,和GoogleScholar数据库用于确定相关的随机对照试验(RCT).为了量化Finerenone的影响,分析包括对汇总平均差(MD)和相对风险(RR)的估计,以及95%置信区间(CI)。这项荟萃分析包括7项针对慢性肾脏病(CKD)和T2D患者的双盲试验。参与者接受了finenerone或安慰剂被随机分配。主要疗效结果是心血管死亡率,非致死性心肌梗死,非致命性中风,心力衰竭住院治疗,肾衰竭,估计肾小球滤过率在四周内从基线持续下降57%,或者肾死亡。在分析中纳入的39,995名患者中,与安慰剂相比,finerenone治疗与心血管和肾脏相关死亡率风险较低相关(RR=0.86(0.80,0.93),p=0.0002;I平方统计量(I2)=0%)和(RR=0.56(0.17,1.82),p=0.34;I2=0%)。此外,finerenone治疗与严重不良事件的风险略有降低相关(RR=0.95(0.92,0.97),p=0.0001;I2=0%),尽管两组之间不良事件的总体风险没有显着差异(RR=1.00(0.99,1.01),p=0.56;I2=0%)。这项研究的发现表明,给予finetenone可以降低终末期肾病的风险,肾功能衰竭,心血管死亡率,和住院。因此,同时患有T2DM和CKD的患者应考虑氟威酮治疗。
The purpose of this study is to assess the safety and efficacy of finerenone therapy in type 2 diabetes mellitus (T2DM) patients with cardiovascular and chronic renal diseases. This meta-analysis assesses the efficacy and safety of finerenone in the treatment of diabetic kidney disease (DKD). A comprehensive search of PubMed, Embase, and Google Scholar databases was performed to identify relevant randomized controlled trials (RCTs). To quantify the effects of finerenone, the analysis included the estimation of aggregated mean differences (MDs) and relative risks (RRs), as well as 95% confidence intervals (CIs). This meta-analysis included seven double-blind trials with patients suffering from chronic kidney disease (CKD) and T2D. Participants received finerenone or a placebo was assigned at random. The primary efficacy outcomes were cardiovascular mortality, non-fatal myocardial infarction, non-fatal stroke, hospitalization for heart failure, kidney failure, a sustained 57% decrease in the estimated glomerular filtration rate from baseline over four weeks, or renal death. Among the 39,995 patients included in the analysis, finerenone treatment was associated with a lower risk of cardiovascular and renal-related mortality compared to placebo (RR = 0.86 (0.80, 0.93), p = 0.0002; I-squared statistic (I2 ) = 0%) and (RR = 0.56 (0.17, 1.82), p = 0.34; I2 = 0%). In addition, finerenone treatment was associated with a marginally reduced risk of serious adverse events (RR = 0.95 (0.92, 0.97), p = 0.0001; I2 = 0%), although no significant difference in the overall risk of adverse events was observed between the two groups (RR = 1.00 (0.99, 1.01), p = 0.56; I2 = 0%). This study\'s findings suggest that finerenone administration can reduce the risk of end-stage kidney disease, renal failure, cardiovascular mortality, and hospitalization. Patients with both T2DM and CKD are therefore advised to consider finerenone therapy.