Kerendia

For use as an adjunct to standard-of-care (SOC) therapy in adult patients diagnosed with BOTH chronic kidney disease (CKD) and type 2 diabetes (T2D) to reduce the risk of end-stage kidney disease and a sustained decrease in estimated glomerular filtration rate (eGFR), and cardiovascular death, nonfatal myocardial infarction, and hospitalization for heart failure in patients who meet the following criteria:

1. 18 years of age or older; AND

2. Diagnosed with CKD with an eGFR level greater than or equal to 25mL/min/1.73 square metres AND an albuminuria level greater than or equal to 30mg/g (or 3mg/mmol); AND

3. Patient is also diagnosed with T2D; AND

4. Finerenone is prescribed in addition to standard-of-care (SOC)* therapy for patients diagnosed with CKD with comorbid T2D; AND
   
   *SOC therapy is defined as maximally tolerated doses of angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) therapy in combination with a sodium-glucose cotransporter-2 (SGLT2) inhibitor unless SGLT2 inhibitors are contraindicated or not tolerated.

5. Patient does not have a diagnosis of chronic heart failure (CHF) with reduced ejection fraction and persistent symptoms meeting New York Heart Association Class II to IV; AND

6. Patient is not using finerenone in combination with another mineralocorticoid receptor antagonist (MRA); AND

7. Finerenone is prescribed in consultation with a nephrologist or other clinician with experience in the diagnosis and management of patients with CKD and T2D.

Discontinuation Criteria:

Patients meeting the initiation criteria and started on finerenone should be discontinued on treatment if the patient's eGFR is less than 15mL/min/1.73 square metres and/or if the urinary albumin-to-creatinine ratio (UACR) has increased from baseline level after starting treatment with finerenone.

Approved Dosage:

- 20mg once daily for patients with an eGFR of at least 60mL/min/1.73 square metres

OR

- 10mg once daily for patients with an eGFR of at least 25mL/min/1.73 square metres to less than 60mL/min/1.73 square metres