Efficacy and Safety of Finerenone in Patients with Heart Failure, Chronic Kidney Disease, and Type 2 Diabetes: A Comprehensive Review of the FINE-HEART Pooled Analysis

Abstract:
This
review article discusses the FINE-HEART pooled analysis, which has investigated
the efficacy and safety of finerenone in patients with heart failure (HF),
chronic kidney disease (CKD), and type 2 diabetes (T2D). Finerenone is a
non-steroidal MRA, which delivers marked value in reducing cardiovascular
mortality, hospitalization due to heart failure, and the progression of kidney
disease, especially in patients with overlapping
cardiovascular-kidney-metabolic (CKM) conditions. Several trial results, including
FIDELIO-DKD and FIGARO-DKD, were combined to provide an overall overview of the
treatment outcomes. The following review discusses the study design, key
results, and clinical implications of finerenone use in high-risk populations
and concludes that finerenone presents substantial benefits in the management
of patients with CKD, HF, and T2D while maintaining an acceptable safety
profile.
References:
[1]. Vaduganathan, M., Filippatos, G., Claggett,
B. L., et al., 2024, Finerenone in heart failure and chronic kidney disease
with type 2 diabetes: FINE-HEART pooled analysis of cardiovascular, kidney and
mortality outcomes. Nature Medicine. https://doi.org/10.1038/s41591-024-03264-4.
[2]. Ostrominski, J. W., et al., 2024,
Cardiovascular-kidney-metabolic overlap in heart failure with mildly reduced or
preserved ejection fraction: a trial-level analysis. Journal of the American
College of Cardiology, 84, 223–228.
[3]. Ndumele, C. E., et al., 2023,
Cardiovascular-kidney-metabolic health: a presidential advisory from the
American Heart Association. Circulation, 148, 1606–1635.
[4]. Bakris, G. L., et al., 2020, Effect of
finerenone on chronic kidney disease outcomes in type 2 diabetes. New
England Journal of Medicine, 383, 2219–2229.
[5]. Agarwal, R., et al., 2022, Cardiovascular and
kidney outcomes with finerenone in patients with type 2 diabetes and chronic
kidney disease: the FIDELITY pooled analysis. European Heart Journal,
43, 474–484.
[6]. Neuen, B. L., et al., 2024, Estimated
lifetime cardiovascular, kidney, and mortality benefits of combination
treatment with SGLT2 inhibitors, GLP-1 receptor agonists, and nonsteroidal MRA
compared with conventional care in patients with type 2 diabetes and
albuminuria. Circulation, 149, 450–462.