Efficacy and Safety of Triple Therapy With Dulaglutide, SGLT2 Inhibitors, and Finerenone in Chinese Adults With Type 2 Diabetes and Chronic Kidney Disease

Exclusion Criteria

• •1.Pregnant or lactating women, or women of childbearing potential unwilling to use reliable contraception
• •2.History of definite contraindications or intolerance to glucagon-like peptide-1 receptor agonists (GLP-1RA), SGLT2 inhibitors, or finerenone
• •3.Type 1 diabetes
• •4.History of diabetic ketoacidosis (DKA) within the past 6 months
• •5.Estimated glomerular filtration rate (eGFR) \<30 mL/min/1.73 m²
• •6.Hospitalization within 30 days prior to screening for acute coronary syndrome (ST-segment elevation myocardial infarction, non-ST-segment elevation myocardial infarction, or unstable angina), percutaneous coronary intervention, or cardiac surgery
• •7.Uncontrolled hypertension, defined as systolic blood pressure ≥160 mmHg and/or diastolic blood pressure ≥100 mmHg (mean of three supine measurements) during screening
• •8.Symptomatic hypotension and/or systolic blood pressure \<90 mmHg at screening, or patients judged by the investigator to have hypovolemia
• •9.Serum potassium \>5.0 mmol/L at screening
• •10.Current use or use within 3 months prior to screening of GLP-1 receptor agonists or other mineralocorticoid receptor antagonists (e.g., spironolactone)
• •11.Patients receiving or with clear clinical indications requiring systemic immunosuppressive therapy (including but not limited to prednisone, cyclosporine, etc.) for other kidney diseases (e.g., primary or secondary glomerulonephritis, lupus nephritis)
• •12.History of recurrent urinary tract or genital infections (as judged by the investigator)
• •13.Life expectancy \<1 year at screening
• •14.Confirmed malignancy
• •15.Participation in another clinical trial within 3 months prior to screening
• •16.Any other condition judged by the investigator as unsuitable for participation in this clinical trial.