Heart failure & cardiomyopathies
Efficacy and Tolerability of Finerenone According to the Use and Dosage of Diuretics: A Prespecified Analysis of the FINEARTS-HF Randomized Clinical Trial
Authors' conclusion
In this secondary analysis of the FINEARTS-HF randomized clinical trial, the efficacy and safety of finerenone were consistent across all diuretic subgroups.
Study context
- Population
- Adults aged ≥40 years with HFmrEF/HFpEF, by baseline diuretic category (nonloop only; loop ≤40 mg or >40 mg furosemide-equivalent; combined nonloop and loop)
- Participants
- 5,438 adults
- Comparison
- Finerenone vs placebo, by baseline diuretic use
- Primary endpoint
- Composite of:
- Total heart failure (HF) events
- CV death
Methodological detailsprespecified, 653 sites in 37 countries
- Prespecified
- 653 sites in 37 countries
Primary result
As reported in the abstract
Total HF events and CV death, by diuretic subgroup
Finerenone vs PlaceboRate ratio (95% CI)
Nonloop (n = 684)
0.84(0.47–1.51)
Loop ≤40 mg (n = 3040)
0.86(0.72–1.02)
Loop >40 mg (n = 1145)
0.98(0.78–1.24)
Combined nonloop and loop (n = 569)
0.54(0.35–0.83)
Further findings
Loop diuretic use
- Finerenone reduced loop diuretic dose and dose intensification, but not loop diuretic initiation, vs placebo
Safety
Safety by diuretic category
- Safety consistent across diuretic categories
Original publication
Efficacy and Tolerability of Finerenone According to the Use and Dosage of Diuretics: A Prespecified Analysis of the FINEARTS-HF Randomized Clinical Trial. JAMA Cardiol. Published 13 August 2025. doi:10.
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