On 10 September, at this year’s European Association for the Study of Diabetes (EASD) congress, during a late-breaking abstract session on the topic of “Advancements in diabetes management and cardiovascular health,” Professor Pardeep Jhund presented findings from an integrated pooled analysis of trials of heart failure (HF) and chronic kidney disease (CKD), FINE-HEART. Jhund focused on Bayer’s Kerendia (finerenone) to highlight the progress made in diabetes management and cardiovascular (CV) death.

The pooled FINE-HEART analysis was conducted with data from the FINEARTS-HF, FIDELIO-DKD, and FIGARO-DKD trials. The findings presented at EASD showed that the use of finerenone reduces the risk of a broad range of outcomes in patients with type 2 diabetes (T2D) who also have CKD or heart failure with mildly reduced ejection fraction (HFmrEF) or heart failure with preserved ejection fraction (HFpEF). In addition, finerenone reduced kidney disease progression, HF hospitalisation, major adverse CV events, and all-cause death in patients with T2D. Jhund emphasised that the benefits were consistent across baseline haemoglobin A1C levels, number and categories of baseline glucose-lowering therapies, and regardless of sodium glucose co-transporter 2 inhibitors or glucagon-like peptide-1 receptor agonists.

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Finerenone is a non-steroidal mineralocorticoid receptor antagonist (MRA). Compared to steroidal MRAs, finerenone has a shorter half-life and a more balanced distribution between the heart and the kidney. Finerenone has been shown to lower the risk of CV events and kidney failure in patients with T2D and CKD, and more recently in patients with HFmrEF/HFpEF without T2D and CKD. The large number of patients in the pooled analysis will likely drive a better understanding of the effects of finerenone in HF and CKD across a broad range of patients. 

A major trend in the HF treatment landscape is that many companies with approved therapies for other CV diseases are testing them in HF patients for potential label extension. For example, HF and kidney disease often co-exist and exacerbate each other; using a combination of drugs for both indications slows the progressive decline of both organs.

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