What TA877 actually recommends (eligibility)
- Finerenone is recommended for stage 3–4 CKD with albuminuria in adults with type 2 diabetes.
- Albuminuria definition (TA877): persistent ACR ≥3 mg/mmol (≥30 mg/g).
- Renal function threshold: eGFR ≥25 ml/min/1.73m².
- Only as add-on to optimised standard care including (unless unsuitable) highest tolerated licensed doses of:
- ACE inhibitor or ARB, and
- SGLT2 inhibitor.
Practical monitoring notes (GP relevance)
- Potassium risk: mineralocorticoid receptor antagonism can raise K+ — check baseline and monitor per shared-care/local renal pathway.
- Drug interactions: review concurrent ACEi/ARB dosing and other K+-raising drugs (e.g., potassium supplements, trimethoprim).
- Positioning: TA877 frames finerenone as an add-on when residual albuminuric risk persists despite optimised standard care.
Transparency
This page is an educational, clinician-written summary of publicly available NICE guidance intended for trained healthcare professionals. It uses original wording (not copied text) and should be used alongside the full NICE source, local pathways, and clinical judgement. Doses provided are for general reference; always check the BNF/SPC.