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Time to implement the #4pillars of “kidney GDMT” - RAS blockade - SGLT2i - ns-MRA - GLP-1 RA Lifetime cardiovascular, kidney & mortality benefits of combination therapy in people with diabetes with albuminuria Now #openaccess in Circulation for #AHA23 ahajournals.org/doi/10.1161/CI…

🎉 Finerenone + Empagliflozin combination ➡️ 52% reduction in uACR in #CONFIDENCE trial 🏆 🤩 #ERA2025 ⁦Rajiv Agarwal MD, MS⁩

In the CONFIDENCE trial in persons with chronic kidney disease and type 2 diabetes, combination therapy with finerenone and empagliflozin led to a greater reduction in the urinary albumin-to-creatinine ratio than either drug alon nejm.org/doi/full/10.10…

Muthu Vaduganathan NEJM Rajiv Agarwal MD, MS Janani Rangaswami Alfonso Valle ERA - European Renal Association Cristina Popa 🦋 Brendon Neuen Diego Segura-Rodríguez GoggleDocs Steve Greene In the room there was applause Muthu Vaduganathan !!! #era2025 #UACR #CONFIDENCE #protecthekidneyandheart

🎶 CONFIDENCE: It Takes Two, Baby 🩺 Combo start of finerenone + empagliflozin in #CKD + #T2D : 📉 UACR ↓ −52% combo −32% finerenone −29% empagliflozin➡️ Combo 29–32% better than monotherapy (p<0.001) 🧪 Effect seen by day 14, peak by day 90 🔁 UACR rebounds after stopping

Original Article: Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes (CONFIDENCE trial) nej.md/4jEVbbk #ERA25 | ERA - European Renal Association

#ACHIEVE largest CVOT (n=2538) of spiro in dialysis neutral CV benefit #ERA25 sMRA in CKM: RALES ✅ EPHESUS ✅ EMPHASIS ✅ TOPCAT ❓ BARACKD ❌ CLEAR ❌ ALCHEMIST ❌ ACHIEVE ❌ SPIRIT SPIRRIT nsMRA in CKM: FIDELIO ✅ FIGARO ✅ FINEARTS✅ CONFIRMATION REDEFINE FINALITY BalanceD

Simultaneous initiation of medications in #CKM may **improve** medication safety. Building on thinking in #HF, new data from #CONFIDENCE presented by Muthu Vaduganathan Heart in Diabetes 🫀 #CME #GDMTworks Yehuda Handelsman MD FACP, FNLA, FASPC, FAHA, MACE

CONFIDENCE: Finerenone with Empagliflozin in CKD and T2D #ERA25 🇦🇹 #Nephpearls 📌 Among persons with both CKD and T2D, initial therapy with finerenone plus empagliflozin led to a greater reduction in the urinary albumin-to-creatinine ratio (UACR) than either treatment alone

How will the #CONFIDENCE trial shape practice in #CKD + #T2D? I spoke with PI Rajiv Agarwal MD, MS after his #ERA25 late-breaker on why a sequential approach may be doing our patients a disservice Full episode: hcplive.com/view/kidney-co… #KidneyCompass #ERA25 #SGLT2i #finerenone

Optimizing the timing and sequencing of guideline-directed medical therapy for T2D and CKD ca. 2024 from Brendon Neuen Katherine Tuttle george bakris George Bakris Muthu Vaduganathan #ERA25 🇦🇹 #Nephpearls #Cardiorenal 👉 pubmed.ncbi.nlm.nih.gov/40179265/

A Nationwide Randomized Trial of Electronic Nudges to General Practices of Patients with CKD for Increasing GDMT (NUDGE-CKD) electronic letter-based nudges on GDMT to general practices treating patients with CKD did not increase uptake of RASi or SGLTi #ERA25

Rationale and design of NUDGE-CKD: A nationwide randomized factorial trial of electronic nudges for increasing guideline-directed medical therapy in CKD #ERA25 Evaluating if a single electronic letter can increase GDMT use in patients with CKD. sciencedirect.com/science/articl…

Can’t get enough of CONFIDENCE? Muthu Vaduganathan and Steve Greene did their own breakdown of the trial at Heart in Diabetes 🫀: hcplive.com/view/don-t-mis…

#NUDGECKD in Circulation #ERA25 by Kristoffer Grundtvig Skaarup & Tor Biering-Sørensen, MD, MSc, MPH, PhD Nationwide 2x2 Pragmatic Implementation Mega-Trial 👥 n=22,617 🇩🇰 adults w #CKD 🥼n=1540 General practitioners Electronic nudges did not improve uptake of #RASi or #SGLT2i versus usual care ahajournals.org/doi/10.1161/CI…

In this pragmatic 2x2 factorial #implementation RCT, w/ randomization at cluster + individual level, electronic letters re #GDMT to general practices & patients w #CKD in did not ⬆️ uptake of #RASi or #SGLT2i ⁦Tor Biering-Sørensen, MD, MSc, MPH, PhD⁩ #NUDGE-CKD Trial ahajournals.org/doi/abs/10.116…

Important data from JACC Journals presented by ambarish NTproBNP tends to increase at 1 yr f/u with weight loss from lifestyle change. Compared with decreases in NTproBNP with #GLP1RA assisted weight loss observed in #HFpEF RCTs Heart in Diabetes 🫀 Yehuda Handelsman MD FACP, FNLA, FASPC, FAHA, MACE #HID2025

Tor Biering-Sørensen, MD, MSc, MPH, PhD does it again! At #ERA25, a 🇩🇰Nationwide 2x2 Care-Embedded Implementation Trial with >20,000 pts & >1500 practices. No 🔼 in #RASi or #SGLT2i with electronic, #BehavioralScience letters. Brilliant work by Kristoffer Grundtvig Skaarup, mentored by Tor Biering-Sørensen, MD, MSc, MPH, PhD. 🙏🏾 for including me!

In an interim analysis of a phase 3 trial involving 800 patients with metabolic dysfunction–associated steatohepatitis, once-weekly semaglutide improved liver histologic results at 72 weeks. Full ESSENCE trial results and Research Summary: nej.md/3EVFAFM