The FIDELITY trial examined finerenone’s impact on heart failure (HF) outcomes in 13,026 patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). Finerenone significantly decreased the risk of HF-related hospitalizations, cardiovascular death, and recurrent HF compared to placebo. Notably, patients with higher baseline estimated glomerular filtration rate (eGFR) and lower urine albumin-to-creatinine ratio (UACR) experienced the lowest incidence of adverse outcomes, yet finerenone consistently improved HF outcomes across all eGFR and/or UACR categories.

These findings highlight finerenone’s potential to ameliorate HF-related outcomes in high-risk T2D patients with CKD, irrespective of their baseline kidney function and albuminuria levels. Further investigation is warranted to elucidate the underlying mechanisms of these benefits and assess the long-term impact of finerenone therapy on cardiovascular outcomes in this patient population.

Reference: Filippatos G, Anker SD, Pitt B, et al. Finerenone and Heart Failure Outcomes by Kidney Function/Albuminuria in Chronic Kidney Disease and Diabetes. JACC Heart Fail. 2022 Nov;10(11):860-870. doi: 10.1016/j.jchf.2022.07.013. Epub 2022 Oct 12. Erratum in: JACC Heart Fail. 2023 Aug;11(8 Pt 1):1034-1035. PMID: 36328655.…