Secondary analysis
Initial Decline in Glomerular Filtration Rate With Finerenone in HFmrEF/HFpEF
- Secondary analysis of the FINEARTS-HF randomised trial
- prespecified analysis
Authors' conclusion
Although an initial decline in eGFR was associated with worse outcomes in patients assigned to placebo, this relationship was not as strong in those treated with finerenone.
Study context
- Population
- Patients with heart failure (HF) (HFmrEF/HFpEF) in FINEARTS-HF with estimated glomerular filtration rate (eGFR) measured at baseline and 1 montheGFR at baseline and 1 month
- Participants
- 5,587 patients
- Comparison
- Initial eGFR decline vs no decline, by finerenone or placebo
- Primary endpoint
- Composite of:
- Total HF events
- CV death
Primary result
As reported in the abstract
Primary outcome with initial eGFR decline (≥15%) vs none, by treatment
eGFR decline vs No eGFR declineAdjusted rate ratio (95% CI)
Placebo
1.50(1.20–1.89)
Finerenone
1.07(0.84–1.35)
Further findings
| Outcome | Finerenone | Placebo | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| ≥15% eGFR decline from randomization to 1 month | 23.0% | 13.4% | 1.95 (1.69–2.24) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
- ≥15% eGFR decline from randomization to 1 month — Overall ≥15% eGFR decline
- 1,018 (18.2%)
Efficacy of finerenone across change in eGFR from baseline to 1 month
- Efficacy of finerenone consistent across the range of eGFR change
- P for interaction = 0.50
Safety
Safety, including hyperkalemia
- Similar regardless of an early eGFR decline
Original publication
Initial Decline in Glomerular Filtration Rate With Finerenone in HFmrEF/HFpEF. J Am Coll Cardiol. Published 21 January 2025. doi:10.1016/j.jacc.2024.11.020
Summarised from the published abstract; every number is checked against it