Cardiology Pharmaceuticals

Better Understanding Finerenone’s HF Impact

Finerenone (Bayer’s Kerendia) seems to be the gift that keeps on giving, and we can now add the ability to reduce worsening HF events in patients on diuresis to its growing list of benefits thanks to a new JAMA substudy of the FINEARTS-HF trial.

  • FINEARTS-HF explored the effects of finerenone in 6k HFmrEF/HFpEF patients and found that the drug significantly reduced worsening HF events and CV death versus placebo.
  • HF patients commonly face periods of stability interrupted by episodes of worsening symptoms and volume retention which causes physicians to put them on diuresis. 
  • Due to financial incentives and patient preference, oral diuretics tend to be more popular than intravenous loop diuretics because they don’t require in-patient care.

Diving deeper into the data from the FINEARTS-HF trial, researchers found that patients who were given more intense diuretic regimens (n=1,250) during worsening HF had nearly 3x higher death rates than those without worsening HF.

  • Patients on intense diuretic regimens faced a death rate of 11.6 per 100 patient-years compared with 4.5 per 100 patient-years for patients without worsening HF who didn’t need diuretics.

Where finerenone really shined was in reducing the death rate in patients on diuretics by cutting down on the need for more intense regimens.

  • Encouragingly, patients on finerenone saw an 11% decrease in diuretic intensification, meaning that finerenone helped avoid the need for intravenous loop diuretics. 
  • This contributed to a 15% reduction in the study’s overall composite endpoint of cardiovascular death, HF hospitalization, and urgent HF visits.

The Takeaway

We already know that finerenone is capable of reducing worsening HF and CV death, but understanding which symptoms it reduces can help us fine tune exactly which patients need it and when, especially as more research trickles in.

Get twice-weekly insights on the biggest stories shaping cardiology.

You might also like

Heart Failure October 20, 2025

Don’t Blame Your Heart for Heart Failure October 20, 2025

Perhaps the biggest cardiology story of the year, an entire issue of JACC now hypothesizes that heart failure with preserved ejection fraction (HFpEF) might actually be caused by visceral fat tissue that triggers cardiac weakening through adipokine signaling. The new unifying adiposity framework now proposes that visceral fat expansion causes secretion of an altered adipokine […]

Cardiology Business October 16, 2025

MedAxiom Report: Cardiologist Compensation Soars, Patient Access Struggles October 16, 2025

Good news and bad news from MedAxiom’s latest cardiology compensation survey. The good news? Cardiologist median compensation reached new record highs last year. The bad news? Patient access deteriorated while the number of patients physicians had to manage swelled. The 2025 survey findings aggregated data across cardiology, cardiac surgery, and vascular surgery specialties, examining compensation […]

Heart Failure October 13, 2025

Specialist Care Can Improve HF Outcomes Across the Board October 13, 2025

A recent study out of the U.K. suggests that multidisciplinary team management could significantly reduce death or rehospitalization risk for HF patients across the LVEF spectrum. Based in a single U.K. county, the Buckinghamshire analysis examined 2.1k patients hospitalized for acute heart failure who received either specialist care or standard care over a 618-day follow-up […]