Finerenone consistently reduced the risk of cardiovascular death and total heart failure events across all categories of heart failure duration compared with placebo (Pinteraction=0.46).
RCT (n=5,977)
Does finerenone reduce the composite of cardiovascular death and total HF events in patients with heart failure across different durations of the disease?
Finerenone provides consistent cardiovascular benefits in heart failure patients regardless of the duration of their disease, including those with long-standing HF and mild functional limitation.
valor p: p=0.46 for interaction
Abstract Aims Clinicians may be less inclined to consider new therapies in patients with long-standing heart failure (HF) due in part to clinical inertia. Whether the treatment effects of the non-steroidal mineralocorticoid receptor antagonist finerenone vary according to HF duration remains uncertain. Methods In this prespecified analysis of the FINEARTS-HF trial, HF duration (defined as the time from diagnosis) was categorized into four groups: 3 months, ≥3 months to 2 years, ≥2 to 5 years, or ≥5 years. The primary outcome was a composite of cardiovascular death and total HF events. The efficacy and safety of finerenone were analyzed across the duration of HF. Results Among 5,977 participants with available data (age: 72±10 years; 46% female), those with longer duration HF were older and had a higher comorbidity burden, while most patients, irrespective of HF duration, had NYHA class II functional status. Compared with HF duration 3 months, longer HF duration experienced a significantly higher adjusted risk of the primary outcome. The benefit of finerenone was consistent across HF duration categories: the rate ratio (95%CI) for the primary outcome in the 3-month group was 0.84 (0.61-1.16); ≥3 months to 2 years, 0.95 (0.74-1.23); ≥2 to 5 years, 0.77 (0.61-0.98); and ≥5 years, 0.81 (0.64-1.02) (Pinteraction=0.46). Drug discontinuation due to serious adverse events was similar between finerenone and placebo, regardless of HF duration. Conclusions These findings suggest that even patients with long-standing HF with only mild functional status limitation may still benefit from further therapeutic optimization with therapies such as finerenone.
Hamatani et al. (Tue,) conducted a rct in Heart failure (n=5,977). Finerenone vs. Placebo was evaluated on Composite of cardiovascular death and total HF events (p=0.46 for interaction). Finerenone consistently reduced the risk of cardiovascular death and total heart failure events across all categories of heart failure duration compared with placebo (Pinteraction=0.46).