Long-term treatment with finerenone is estimated to extend event-free survival among people with heart failure with mildly reduced or preserved ejection fraction, according to a brief report published online Sept. 27 in JAMA Cardiology to coincide with the annual meeting of the Heart Failure Society of America, held virtually from Sept. 27 to 30.

Muthiah Vaduganathan, M.D., M.P.H., from Harvard Medical School in Boston, and colleagues estimated the long-term treatment effects of finerenone if treated during a patient’s lifetime in patients with heart failure with mildly reduced or preserved ejection fraction.

Analyses included data from the FINEARTS-HF trial, which was conducted in 37 countries across 653 sites. Participants, who were aged 40 years and older and had symptomatic heart failure and left ventricular ejection fraction of 40% or higher, were randomly assigned to finerenone (titrated to 20 or 40 mg) or placebo; 6,001 participants were included in the analysis.

The researchers found that for a 55-year-old participant, mean survival free from the primary composite outcome of time to cardiovascular death or worsening heart failure event was 13.6 and 10.5 years with finerenone and placebo, respectively, representing a gain of 3.1 years in event-free survival. For a 65-year-old participant, mean event-free survival was 11.0 and 8.9 years with finerenone and placebo, respectively, representing a gain of 2.0 years.

For every starting age between 50 and 80 years, the projected mean event-free survival was numerically greater with finerenone versus placebo. Even among individuals already treated with a sodium-glucose cotransporter 2 inhibitor, there were lifetime gains in event-free survival observed (3.1 years for a 65-year-old participant).

“The relative benefits reported during follow-up in the FINEARTS-HF trial can be interpreted together with these new projections of the expected absolute benefits with lifetime use of finerenone,” the authors write.

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