NCT05640180: FLAMINGO

An Observational Study Called FLAMINgO to Learn More About the Treatment Combination of Finerenone and SGLT2 Inhibitors in People With Long-term Kidney Disease (Chronic Kidney Disease) Together With Type 2 Diabetes by Using Routine Medical Care Data and Past Clinical Study Results

Completed Last updated 8 January 2024

What this trial tests

trial testing Finerenone (Kerendia, BAY94-8862) in Chronic Kidney Disease in 17,847 participants. Completed in 20 December 2023.

Timeline

23 November 2022

Primary endpoint
20 December 2023

20 December 2023

Quick facts

Lead sponsor	Bayer
Status	Completed
Study type	OBSERVATIONAL
Enrollment	17,847
Start date	23 November 2022
Primary completion	20 December 2023
Estimated completion	20 December 2023
Sites	1 location across United States

Drugs / interventions tested

• Finerenone (Kerendia, BAY94-8862) — full drug profile →
• Sodium-glucose cotransporter-2 inhibitors (SGLT2i)

Conditions studied

• Chronic Kidney Disease — all drugs for Chronic Kidney Disease →
• Type 2 Diabetes — all drugs for Type 2 Diabetes →

Sponsor

Bayer — full company profile →

Who can join

18 and older, any sex, with Chronic Kidney Disease or Type 2 Diabetes. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

This is an observational study, in which data from the past of people with chronic kidney disease (CKD) together with type 2 diabetes (T2D) are studied. The participants in this study were treated in the past with a type of drug called SGLT2 inhibitor alone or with SGLT2 inhibitors in combination with finerenone.

In observational studies, only observations are made without specified advice or interventions.

CKD is a long-term progressive decrease in the kidneys' ability to work properly. In people with T2D, the body does not make enough of a hormone called insulin, or does not use insulin well enough, resulting in high blood sugar levels that can cause damage to the kidneys. Chronic kidney disease often occurs together with / as a consequence of type 2 diabetes.

SGLT2 inhibitors lower blood sugar levels by increasing sugar removal from the blood into the urine. SGLT2 inhibitors are the standard of care (SOC) treatment for CKD and T2D. SOC is the treatment that medical experts consider most appropriate for a disease. The drug finerenone works by blocking certain proteins, called mineralocorticoid receptors.

By doing this, finerenone reduces damage to kidneys, heart and blood vessels. It is available and approved for doctors to prescribe to people with CKD together with T2D.

Results from two earlier clinical studies called FIDELIO-DKD and FIGARO-DKD in participants with CKD together with T2D are available. These results suggest that the treatment combination of finerenone and SGLT2 inhibitors may work better than taking SGLT2 inhibitors alone. The treatment combination may further slow down a worsening of the participants'

* kidney disease
* heart and blood circulation health.

Due to a limited number of participants treated with SGLT2 inhibitors alone however, the data from the two earlier studies does not allow to draw conclusions.

The main objective of this study is to combine additional real world data from SGLT2 inhibitor users with the study data from the earlier studies to get clearer results. Before combining the data however, statistical tests need to prove that this is allowed. If this is the case, the new combined "control" data can be compared with the data from the combination treatment group from the earlier studies. This will allow the researchers to get more proof and draw conclusions of how well the treatment combination works compared to SGLT2 inhibitors alone.

The real world data will come from a database called Optum. It will cover the period from January 2013 to September 2021. Only data from people who are similar to the participants of the control group of the earlier studies and meet certain criteria will be selected.

Only data from the past is collected and studied. There are no required visits or tests in this study.

Publications & conference data

3 peer-reviewed publications reference this trial (live from Europe PMC):

1. Kidney and cardiovascular-protective benefits of combination drug therapies in chronic kidney disease associated with type 2 diabetes.
   Khan MS, Lea JP. · · 2024 · cited 12× · PMID 39090593 · DOI 10.1186/s12882-024-03652-5
2. Finerenone: Potential Clinical Application Across the Spectrum of Cardiovascular Disease and Chronic Kidney Disease.
   Haq N, Uppal P, Abedin T, Lala A. · · 2025 · cited 1× · PMID 40364247 · DOI 10.3390/jcm14093213
3. External Control Augmentation Increases Estimates Precision for Finerenone plus Sodium-Glucose Cotransporter-2 Inhibitors.
   Boemmel-Wegmann SV, Bauer C, Zerck A, Hartenstein A, et al · · 2026 · PMID 42006210 · DOI 10.1016/j.ekir.2026.106409