Kerendia (finerenone), a treatment for chronic kidney disease, has strengthened its clinical presence by demonstrating efficacy in combination with the SGLT-2 inhibitor Jardiance (empagliflozin).

Kerendia is the first non-steroidal mineralocorticoid receptor antagonist (MRA), with a novel mechanism of action that directly suppresses inflammation and fibrosis in the kidney.

In June, results from the CONFIDENCE study drew attention by confirming the benefit of early combination therapy with SGLT-2 inhibitors.

The trial included 818 patients with type 2 diabetes and CKD (eGFR 30–90 mL/min/1.73m², urine albumin-to-creatinine ratio [UACR] ≥100–<5,000 mg/g).

Results showed that at day 180, UACR was reduced by an average of 52% from baseline in the combo arm. This represented a 29% greater reduction vs. Kerendia alone and 32% greater vs. SGLT-2 inhibitor alone.

Using both drugs simultaneously achieved the treatment goal of reducing UACR by at least 30% from baseline at 180 days after initiation at a 20% higher rate compared to patients using only one of the two drugs.

The results show that initiating therapy with two agents of different mechanisms of action early can deliver stronger reductions in albuminuria at 6 months, signaling a paradigm shift in CKD treatment.

With Jardiance newly reimbursed for adult CKD patients in Korea since August, experts suggest doctors can proactively combine both agents for more effective treatment.

Prof. Jung-Pyo Lee (Department of Nephrology, Boramae Medical Center (Secretary General, Korean Society of Nephrology), said, “Both Kerendia and Jardiance are important therapies for CKD. Baed on the new evidence, the combined use of the two will provide an additional treatment option that will be increasingly used in practice.

According to Professor Lee, doctors may consider the use of Kerendia+Jardiance in diabetic CKD patients, especially those with significant proteinuria. Physicians are already beginning to prescribe the combination proactively.

Kerendia’s growing use is also raising expectations for increasing the drug’s sales momentum. According to UBIST, Kerendia’s 2023 prescriptions totaled KRW 5.3 billion.

In H1 2025 alone, sales reached KRW 7.6 billion — already surpassing last year’s full total. With monthly sales of around KRW 1.4 billion, annual revenue may reach KRW 20 billion if the trend continues.

Additionally, Kerendia recently received US FDA approval for extended indications in heart failure with mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF, ≥40%). A similar extension is therefore expected in Korea as well.

Prof. Yong-Ho Lee (Endocrinology, Severance Hospital; Secretary General, Korean Diabetes Association) said, “Despite the use of GLP-1 receptor agonists, SGLT-2 inhibitors, and RAS inhibitors, residual risk remained in diabetic kidney disease. With its proven efficacy across multiple trials, Kerendia is becoming a key treatment option for CKD patients.”