Cardiovascular Events with Finerenone in Kidney Disease and Type 2 Diabetes

The FIGARO-DKD trial evaluated the cardiovascular effects of finerenone, a nonsteroidal mineralocorticoid receptor antagonist, in patients with type 2 diabetes and chronic kidney disease (CKD). The study involved 7,437 participants randomized to receive finerenone or placebo. Over a median follow-up of 3.4 years, finerenone significantly reduced the primary composite outcome of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure by 13% (hazard ratio [HR] 0.87; 95% CI, 0.76–0.98; P=0.03), driven primarily by a lower incidence of heart failure hospitalization (HR 0.71; 95% CI, 0.56–0.90). The secondary kidney outcome showed no significant difference. Hyperkalemia was more frequent with finerenone (10.8% vs. 5.3%), but discontinuation rates were low. 

The FIGARO-DKD trial evaluated the cardiovascular effects of finerenone, a nonsteroidal mineralocorticoid receptor antagonist, in patients with type 2 diabetes and chronic kidney disease (CKD). The study involved 7,437 participants randomized to receive finerenone or placebo. Over a median follow-up of 3.4 years, finerenone significantly reduced the primary composite outcome of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure by 13% (hazard ratio [HR] 0.87; 95% CI, 0.76–0.98; P=0.03), driven primarily by a lower incidence of heart failure hospitalization (HR 0.71; 95% CI, 0.56–0.90). The secondary kidney outcome showed no significant difference. Hyperkalemia was more frequent with finerenone (10.8% vs. 5.3%), but discontinuation rates were low.