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Heart failure

Finerenone vs eplerenone for patients with HFrEF

Nature Reviews Cardiology volume 13, page 381 (2016)Cite this article

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Although the steroidal mineralocorticoid-receptor antagonists (MRAs) spironolactone and eplerenone are currently guideline-recommended for patients with heart failure with reduced ejection fraction (HFrEF), they are often underprescribed in patients with worsening HFrEF owing to high risk of adverse events. The randomized, double-blind, phase IIb ARTS-HF study was designed to assess the efficacy of the novel nonsteroidal MRA finerenone in patients with worsening HFrEF and chronic kidney disease and/or diabetes mellitus. Finerenone was well tolerated and induced a ≥30% decrease in plasma N-terminal pro-B-type natriuretic peptide levels in a similar proportion of patients to eplerenone. Furthermore, patients in the finerenone 10–20 mg dose group had the largest reduction in the composite outcome of death from any cause, cardiovascular hospitalization, or emergency presentation to hospital compared with patients in the eplerenone group. According to the investigators, these results “indicate that the 10 mg once-daily dose of finerenone, uptitrated to 20 mg after 30 days, would provide the best balance of safety and efficacy for further investigation in larger clinical trials”.

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References

  1. Filippatos, G. et al. A randomized controlled study of finerenone vs. eplerenone in patients with worsening chronic heart failure and diabetes mellitus and/or chronic kidney disease. Eur. Heart J. http://dx.doi.org/10.1093/eurheartj/ehw132 (2016)

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  1. Karina Huynh
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Huynh, K. Finerenone vs eplerenone for patients with HFrEF. Nat Rev Cardiol 13, 381 (2016). https://doi.org/10.1038/nrcardio.2016.82

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