Cardiovascular Efficacy and Safety of Finerenone: A Meta-Analysis of Randomized Controlled Trials

Overview

Journal Clin Cardiol

Date 2025 Feb 6

PMID 39911073

Authors

Mushood Ahmed

Areeba Ahsan

Aimen Shafiq

Muhammad Talha Maniya

Hritvik Jain

Javed Iqbal

Muhammad Abdullah Naveed

Raheel Ahmed

Jamal S Rana

Marat Fudim

Gregg C Fonarow

Affiliations

Soon will be listed here.

Abstract

Background: Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, has emerged as a novel therapeutic option for the management of patients with diabetes, chronic kidney disease, or heart failure. We seek to summarize the evidence on the drug's effectiveness regarding cardiovascular (CV) outcomes.

Methods: We conducted a literature search of Pubmed, Cochrane CENTRAL, Embase, and ClinicalTrials.gov from inception to September 2024. Trials exploring the effects of finerenone on CV outcomes were extracted and analyzed. The results of pooled analyses were presented as risk ratios (RRs) with 95% confidence intervals (CIs).

Results: A total of eight trials, incorporating 21 200 patients, were included. The pooled analysis demonstrated a significant reduction in all-cause death (RR 0.92, 95% CI: 0.85-0.99), major adverse CV events (RR 0.85, 95% CI: 0.81-0.90), heart failure-related hospitalizations or unplanned hospital visits (RR 0.82, 95% CI: 0.76-0.87) with finerenone administration compared to control. Finerenone use was associated with a trend of reduced risk of CV death without reaching statistical significance (RR 0.90, 95% CI: 0.81-1.00). The risk of myocardial infarction (RR 0.91, 95% CI: 0.74-1.12), adverse events (RR 0.96, 95% CI: 0.89-1.03), adverse events leading to discontinuation (RR 1.06, 95% CI: 0.96-1.17) remained comparable across both groups. However, an increased risk of hyperkalemia (RR 2.07, 95% CI: 1.88-2.27) was observed with finerenone therapy compared to the control group.

Conclusion: Finerenone administration was associated with improved CV outcomes in the CV-renmetabolic conditions compared to the control group.

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