SGLT2 inhibitors, semaglutide, and finerenone in diabetic kidney disease: a Bayesian network meta-analysis
He Z, Wang X, Zhang L, et al. (2026). Frontiers in Pharmacology.
Summary
A Bayesian network meta-analysis comparing three drug classes with phase 3 kidney and heart outcome data in type 2 diabetes with chronic kidney disease: SGLT2 inhibitors, semaglutide and finerenone. It pooled six trial datasets covering 20,521 people. All three reduced cardiovascular risk against placebo, with no significant differences between them. On kidney outcomes, SGLT2 inhibitors ranked first, semaglutide second and finerenone third; semaglutide was numerically but not significantly ahead of finerenone. The authors note that the one significant indirect difference, SGLT2 inhibitors over finerenone, depends on analysing the two finerenone trials separately and treat it as hypothesis-generating.