866-P: Assessing the Generalizability of the FIDELIO-DKD and FIGARO-DKD Criteria to the Canadian Population with Type 2 Diabetes in a Community Endocrinology Setting
Bibliographic record
Abstract
Finerenone improves renal and cardiovascular outcomes in CKD and T2D, as demonstrated in the FIDELIO and FIGARO trials. While the ADA guidelines advise finerenone for residual renal risk, Canadian guidelines lack such recommendations. Previous studies established the applicability of the FIDELIO and FIGARO inclusion criteria to the US population. This study aims to assess if these criteria similarly apply to the Canadian population. We applied the FIDELIO and FIGARO trial criteria to Canadians with T2D in a community endocrinology setting, who were already optimized for renal risk with RAAS and SGLT2 therapy. Of 369 individuals with T2D optimized on RAAS and SGLT2 inhibitors, 99 (27%) met FIDELIO or FIGARO criteria. Population characteristics were comparable with the inclusion trials, with median age 71, mean A1c 7.7%, mean eGFR 57, median uACR 284.9 mg/g, and mean SBP 132. Our study population had a higher prevalence of prior myocardial infarction compared to those in the inclusion trials (26.2% vs 7.4% and 13.2%, p <0.05). Despite Health Canada approval of finerenone, adoption into clinical practice remains slow. We found that 27% of individuals carry residual renal risk despite optimization. The higher proportion of patients in our study with history of cardiovascular disease emphasizes the need to implement finerenone into Canadian guidelines. Disclosure A. Jazdarehee: None. A.B. Jain: Advisory Panel; Abbott. Speaker's Bureau; Abbott. Advisory Panel; Boehringer-Ingelheim. Speaker's Bureau; Boehringer-Ingelheim. Advisory Panel; Amgen Inc. Speaker's Bureau; Amgen Inc., AstraZeneca. Advisory Panel; AstraZeneca. Speaker's Bureau; Care to Know, CCRN, Connected in Motion, CPD Network, Dexcom, Diabetes Canada, Eli Lilly, GSK, HLS Therapeutics, Janssen, Master Clinician Alliance, MDBriefcase, Merck, Medtronic, Moderna, Novartis, N. Advisory Panel; Bausch Healthcare, Bayer,, Dexcom, Eli Lilly, Gilead Sciences, GSK, HLS Therapeutics, Insulet, Janssen, Medtronic, Novo Nordisk, Partners in Progressive Medical Education, Pfizer, PocketPills, Roche,.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.031 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".