Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Spatial Analysis of Colorectal Cancer Incidence in Hamadan Province, Iran: a Retrospective Cross-Sectional Study

Abstract Colorectal Cancer (CRC) is ranked the third most common cancer in women and the fourth in men in Iran. Many factors contribute to CRC occurrence, and most of them are interrelated. The present study aimed to explore the spatial pattern of CRC incidence in Hamadan province, Iran. We collected and analyzed data on patients’ location, gender, age, and date of diagnosis recorded in the CRC registry between 2007 and 2014 in Hamadan province. The Anselin Local Moran’s I statistic was conducted to identify clusters and outliers of CRC distribution. There were 805 recorded CRC cases in Hamadan province during 2007–2014, with an incidence of 45.89 patients per 100,000 people. Three significant clusters of both high and low incidence rate were found in the study area. This research demonstrated significant geographical disparities in CRC incidence in Hamadan province. The spatial analysis of CRC incidence pattern generates new hypothesis on effect of location in disease clusters. These findings may shine light on underlying risk factors in areas where the CRC risk is greater and how contextual factors may play a role in CRC geographic disparity. Keywords Colorectal cancer . Geographical information system . Iran . Spatial analysis . Cluster analysisWe would like to thank Hamadan University of Medical Sciences because of funding this project