Finerenone Shown To Benefit Heart and Lower Type 2 Diabetes Risk
Key takeaways:
- Finerenone (brand name Kerendia) is an oral medication originally approved for people with chronic kidney disease and type 2 diabetes. The FDA recently expanded the uses of finerenone to include treating heart failure.
- Recent research also shows that finerenone reduces the risk of new-onset diabetes in people with heart failure.
- Currently, finerenone is the only drug of its kind approved for adults with heart failure.
Finerenone has now been officially approved to treat heart failure, with past research showing the drug offers benefits beyond treating chronic kidney disease in people with type 2 diabetes.
A 2025 study found that finerenone also reduced the risk of developing type 2 diabetes in people with heart failure by about 25%. An earlier 2024 study found that the medication also showed heart health benefits, delaying the progression of heart failure and reducing the risk of cardiovascular death.
“Hopefully, reducing the incidence of new-onset diabetes means that these heart failure patients might have a better quality of life and be at lower subsequent risk of hospitalization and death,” said Dr. John McMurray, a professor of cardiology at the University of Glasgow and Queen Elizabeth University Hospital.
With all the positive research results, the FDA approved the use of finerenone for heart failure in July 2025. Specifically, finerenone's uses have expanded to reduce cardiovascular death, hospitalization for heart failure, and urgent heart failure visits in those with a left ventricular ejection fraction (how much blood your heart pumps per beat) of 40% or more.
What does the research say?
The new approval is based on data that comes from the FINEARTS-HF clinical trial, which was sponsored by Bayer and included more than 6,000 subjects from dozens of countries with and without type 2 diabetes. Participants were randomized to receive either finerenone (20 or 40 mg daily, depending on kidney function) or a placebo in addition to their existing medications.
Data from the trial showed that finerenone reduced worsening heart failure events, such as unplanned hospitalization or urgent visits for heart failure, as well as cardiovascular-related death by 16% when compared with the placebo. Further analysis demonstrated that finerenone also reduced the incidence of new-onset type 2 diabetes by approximately 25% in patients with heart failure.
A new first-line treatment for heart failure
Heart failure is a serious and progressive condition. It is also one of the most common complications of diabetes.
To date, treatment options for heart failure have been extremely limited. In the past, a class of drugs known as steroidal mineralocorticoid receptor antagonists (MRAs) has been used to treat it, but their effectiveness in delaying the progression of heart failure was limited.
“We did not have clear evidence that drugs in this class are effective in [heart failure] patients with an ejection fraction above 40%,” McMurray explained.
The FINEARTS-HF trial proved that finerenone can delay the progression of certain common types of heart failure. Finerenone is a non-steroidal MRA – currently the only one in its drug class. While more expensive, it has a different chemical structure from older steroidal MRAs, as well as fewer side effects.
Reducing the risk of developing diabetes
Heart failure can increase the risk for diabetes – and vice versa. That means for people managing heart failure without diabetes, finerenone offers additional protection in lowering the risk of new-onset type 2 diabetes.
“There is clearly a detrimental relationship between heart failure and diabetes that has a huge and harmful impact on symptoms and outcomes in patients,” McMurray said.
He added that participants who received finerenone reported an improved quality of life, fewer symptoms, and the ability to do more. Additional trials are ongoing to assess finerenone in treating other types of heart failure, as well as for chronic kidney disease in type 1 diabetes.
Learn more about treatments for kidney and heart health here: