Use of Clinical-trials and Simulation Models to Estimate Cost-effectiveness of Non-steroidal Mineralocorticoid Antagonists, RASi and SGLT2i as Triple Therapy With Type 2 Diabetes and Chronic Kidney Disease

Exclusion Criteria

• •Type 1 diabetes
• •Allergy, contraindications or intolerance to ACEi/ARB
• •Contraindications or intolerance to mineralocorticoid receptor antagonists
• •Allergy, contraindications to SGLT2is
• •Currently pregnant or planning pregnancy
• •HbA1c \>9% at enrolment
• •Uncontrolled hypertension SBP \> 160mmHg or hypotension \<90 mmHg at enrolment
• •Concomitant therapy with eplenerone, spironolactone that cannot be discontinued.
• •History of stroke or worsening heart failure in the past 6 months prior to screening
• •Diabetic ketoacidosis, hyperosmolar hyperglycaemic state or myocardial infarction in the six months prior to screening
• •Patients on renal replacement therapy or likely require kidney transplant or dialysis during the study period
• •On concomitant strong CYP3A4 inhibitors that cannot be discontinued
• •Adrenal insufficiency
• •Currently participating in another investigational study protocol where the testing or results may interfere with study compliance, diagnostic results, or data collection.
• •An identified protected vulnerable patient (including but not limited to those in detention, or a prisoner).