FINEARTS-HF (secondary analysis)
Trial question
What is the effect of finerenone in patients with worsening HFmrEF or HFpEF?
Study design
Multi-center
Double blinded
RCT
Population
Characteristics of study participants
46.0% female
54.0% male
N = 6001
6001 patients (2732 female, 3269 male).
Inclusion criteria: patients with worsening HFmrEF or HFpEF.
Key exclusion criteria: receipt of any mineralocorticoid receptor antagonist within 30 days of randomization or continuously in the 12 months before screening; eGFR < 25 mL/min/1.73 m²; serum potassium > 5.0 mmol/L; acute inflammatory heart disease or CABG surgery within 90 days prior to randomization; PCI within 30 days prior to randomization.
Interventions
N=3003 finerenone (at a maximum dose of 20-40 mg once daily plus usual therapy).
N=2998 placebo (matching placebo once daily plus usual therapy).
Primary outcome
Outpatient oral diuretic intensification
756 events
832 events
832.0 events
624.0 events
416.0 events
208.0 events
0.0 events
Finerenone
Placebo
Significant
decrease ▼
Significant decrease in outpatient oral diuretic intensification (756 events vs. 832 events; HR 0.89, 95% CI 0.8 to 0.98).
Secondary outcomes
Significant decrease in CV death, HF hospitalization, urgent HF visit, or outpatient oral diuretic intensification (1049 events vs. 1189 events; HR 0.85, 95% CI 0.78 to 0.92).
Significant decrease in CV death, HF hospitalization, or urgent HF visit (624 events vs. 719 events; HR 0.84, 95% CI 0.76 to 0.94).
No significant difference in CV death (242 events vs. 260 events; HR 0.93, 95% CI 0.78 to 1.11).
Conclusion
In patients with worsening HFmrEF or HFpEF, finerenone was superior to placebo with respect to outpatient oral diuretic intensification.
Reference
Jonathan W Cunningham, Safia Chatur, Brian L Claggett et al. Finerenone and Outpatient Worsening Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Secondary Analysis of the FINEARTS-HF Randomized Clinical Trial. JAMA Cardiol. 2025 Feb 26:e250016. Online ahead of print.
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