Finorenone: New Therapy to Reduce Heart Failure and Cardiovascular Mortality?

Finerenone demonstrated a reduction in the combined incidence of initial and recurrent heart failure (HF) events, which include hospitalizations for HF or urgent visits related to HF. It also reduced cardiovascular mortality in patients with heart failure and either mildly reduced or preserved ejection fraction (1^✔ ✔Trusted Source
Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction

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Comparison of Finerenone and Placebo Shows Potential for New Therapy

This finding was observed from an international clinical trial conducted by researchers at Brigham and Women’s Hospital, a founding institution of the Mass General Brigham healthcare system. The occurrence of heart failure events and cardiovascular deaths was notably lower in the finerenone cohort compared to the placebo cohort. While the overall incidence of serious adverse events was comparable between the two groups, the finerenone group exhibited a higher incidence of hyperkalemia, characterized by elevated potassium levels in the bloodstream. These findings were presented at the European Society of Cardiology Congress 2024 and were concurrently published in the New England Journal of Medicine.

“We saw benefit regardless of the ejection fraction and even in patients who were on other approved therapies,” said trial principal investigator and corresponding author Scott Solomon, MD, the director of the Clinical Trials Outcomes Center at Mass General Brigham and the Edward D. Frohlich Distinguished Chair at Brigham and Women’s Hospital. “This drug represents a new drug class that may become a pillar of therapy for this disease.”

Heart failure (HF) is characterized by a gradual deterioration in the heart's capacity to adequately fill with and circulate blood. This condition impacts more than 60 million individuals globally. Roughly 50% of those diagnosed with HF exhibit either mildly reduced or preserved left ventricular ejection fraction, a condition that currently has few treatment options. These observations indicate that finerenone, a non-steroidal mineralocorticoid receptor antagonist, may serve as a novel therapeutic option for affected patients.

The FINEARTS-HF trial was funded by Bayer. It allocated 6,000 patients to receive either finerenone or a placebo along with their current treatments. A limitation of the trial is the underrepresentation of Black patients, though their proportion matched the regional population. “Our group continues to study novel therapies for heart failure,” Solomon said. “There’s a huge residual risk in these patients and so more room for new therapies.“

Reference:

1. Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction - (https://www.nejm.org/doi/10.1056/NEJMoa2407107)

Source-Eurekalert