Evidence map›Paper›PMID 39340828›Full record

Trial reportCirculation2025

Effects of the Nonsteroidal MRA Finerenone With and Without Concomitant SGLT2 Inhibitor Use in Heart Failure.

Muthiah Vaduganathan, Brian L Claggett, Ian J Kulac, Zi Michael Miao, Akshay S Desai, Pardeep S Jhund, Alasdair D Henderson, Meike Brinker, James Lay-Flurrie, Prabhakar Viswanathan and 10 more

Registry-linked trialAbstract readClinical Trial, Phase IIIMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04435626 (A Multicenter, Randomized, Double-blind, Parallel-group, Placebo-controlled Study to Evaluate the Efficacy and Safety of Finerenone on Morbidity and Mortality in Participants With Heart Failure), which is not on this map. Cited by 39 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04435626 phase3completednot on this map

A Multicenter, Randomized, Double-blind, Parallel-group, Placebo-controlled Study to Evaluate the Efficacy and Safety of Finerenone on Morbidity and Mortality in Participants With Heart Failure (NYHA II-IV) and Left Ventricular Ejection Fraction ≥ 40% (LVEF ≥ 40%)

TypeinterventionalSponsorBayerRan2020 to 2024Enrolled6,016ConditionsHeart FailureArmsFinerenone (BAY94-8862), Placebo
3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  15. Transdermal Clonidine for Hypertension: An Underutilized Ally in the Modern Era.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Muthiah VaduganathanBrigham and Women's Hospital, Harvard Medical School, Boston, MA (M.V., B.L.C., I.J.K., Z.M.M., A.S.D., S.D.S.).ORCID 0000-0003-0885-1953
Brian L ClaggettBrigham and Women's Hospital, Harvard Medical School, Boston, MA (M.V., B.L.C., I.J.K., Z.M.M., A.S.D., S.D.S.).ORCID 0000-0002-4215-9218
Ian J KulacBrigham and Women's Hospital, Harvard Medical School, Boston, MA (M.V., B.L.C., I.J.K., Z.M.M., A.S.D., S.D.S.).ORCID 0000-0002-0710-1088
Zi Michael MiaoBrigham and Women's Hospital, Harvard Medical School, Boston, MA (M.V., B.L.C., I.J.K., Z.M.M., A.S.D., S.D.S.).ORCID 0000-0002-2377-1444
Akshay S DesaiBrigham and Women's Hospital, Harvard Medical School, Boston, MA (M.V., B.L.C., I.J.K., Z.M.M., A.S.D., S.D.S.).ORCID 0000-0002-1443-0701
Pardeep S JhundUniversity of Glasgow, UK (P.S.J., A.D.H., J.J.V.M.).ORCID 0000-0003-4306-5317
Alasdair D HendersonUniversity of Glasgow, UK (P.S.J., A.D.H., J.J.V.M.).ORCID 0000-0002-8903-4906
Meike BrinkerResearch & Development, Pharmaceuticals, Bayer, Berlin, Germany (M.B., J.L.-F., P.V., M.F.S., A.L.).ORCID 0000-0002-1560-9535
James Lay-FlurrieResearch & Development, Pharmaceuticals, Bayer, Berlin, Germany (M.B., J.L.-F., P.V., M.F.S., A.L.).
Prabhakar ViswanathanResearch & Development, Pharmaceuticals, Bayer, Berlin, Germany (M.B., J.L.-F., P.V., M.F.S., A.L.).
Markus Florian ScheererResearch & Development, Pharmaceuticals, Bayer, Berlin, Germany (M.B., J.L.-F., P.V., M.F.S., A.L.).
Andrea LageResearch & Development, Pharmaceuticals, Bayer, Berlin, Germany (M.B., J.L.-F., P.V., M.F.S., A.L.).ORCID 0000-0002-9893-2759
Carolyn S P LamNational Heart Centre Singapore & Duke-National University of Singapore (C.S.P.L.).ORCID 0000-0003-1903-0018
Michele SenniPapa Giovanni XXIII Hospital, University of Milano-Bicocca, Bergamo, Italy (M.S.).ORCID 0000-0001-5502-7882
Sanjiv J ShahNorthwestern University Feinberg School of Medicine, Chicago, IL (S.J.S.).ORCID 0000-0002-5655-8201
Adriaan A VoorsUniversity of Groningen, Netherlands (A.A.V.).ORCID 0000-0002-5417-4415
Faiez ZannadUniversity of Lorraine, Nancy, France (F.Z.).ORCID 0000-0001-7456-1570
Bertram PittUniversity of Michigan, Ann Arbor (B.P.).ORCID 0000-0001-7703-0345
John J V McMurrayUniversity of Glasgow, UK (P.S.J., A.D.H., J.J.V.M.).ORCID 0000-0002-6317-3975
Scott D SolomonBrigham and Women's Hospital, Harvard Medical School, Boston, MA (M.V., B.L.C., I.J.K., Z.M.M., A.S.D., S.D.S.).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with heart failure (HF) with mildly reduced or preserved ejection fraction face heightened long-term risks of morbidity and mortality. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and the nonsteroidal mineralocorticoid receptor antagonist finerenone have both been shown to reduce the risk of cardiovascular events in this population, but the effects of their combined use are not known.

methodsFINEARTS-HF (Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients With Heart Failure) was a randomized, double-blind, placebo-controlled trial of finerenone in patients with HF and left ventricular ejection fraction ≥40%. Baseline SGLT2i use was a prespecified subgroup. The primary outcome was a composite of total (first and recurrent) worsening HF events and cardiovascular death. We first assessed for evidence of treatment heterogeneity on the basis of baseline SGLT2i use. We further examined SGLT2i uptake during the trial and evaluated the treatment effects of finerenone accounting for baseline and during-trial use of SGLT2i in time-varying analyses.

resultsAmong 6001 participants, 817 (13.6%) were treated with an SGLT2i at baseline. During 2.6 years median follow-up, treatment with finerenone similarly reduced the risk of the primary outcome in participants treated with an SGLT2i (rate ratio, 0.83 [95% CI, 0.60-1.16]) and without an SGLT2i at baseline (rate ratio, 0.85 [95% CI, 0.74-0.98];

conclusionsThe treatment benefits of the nonsteroidal mineralocorticoid receptor antagonist finerenone were observed irrespective of concomitant use of an SGLT2i. These data suggest that the combined use of SGLT2i and a nonsteroidal mineralocorticoid receptor antagonist may provide additive protection against cardiovascular events in patients with HF with mildly reduced or preserved ejection fraction. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04435626.

Indexed as

Heart FailureMineralocorticoid Receptor AntagonistsNaphthyridinesSodium-Glucose Transporter 2 InhibitorsAgedDouble-Blind MethodDrug Therapy, CombinationFemaleHumansMaleMiddle AgedStroke VolumeTreatment OutcomefinerenoneMineralocorticoid Receptor AntagonistsNaphthyridinesSodium-Glucose Transporter 2 Inhibitorsaldosteroneheart failuremineralocorticoid receptor antagonistssodium-glucose transporter 2 inhibitorstherapeutics

Identifiers

PMID39340828
PMCPMC11732259

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.