Heart failure & cardiomyopathiesSecondary analysis

Efficacy and Tolerability of Finerenone According to the Use and Dosage of Diuretics

JAMA CardiolPublished

  • Secondary analysis of the FINEARTS-HF randomised trial
  • prespecified
  • 653 sites in 37 countries

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

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. JAMA Cardiol. Published 13 August 2025. doi:10.1001/jamacardio.2025.2551

Summarised from the published abstract; every number is checked against it