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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EARTS-HF study demonstrated that finerenone had a comparable efficacy with eplerenone in reducing N-terminal pro-brain natriuretic peptide and a greater efficacy in reducing the incidence of the composite of all-cause death, cardiovascular hospitalization, or emergency presentation for worsening chronic heart failure in patients with heart failure with reduced ejection fraction and type 2 diabetes or chronic kidney disease. However, caution is required in interpreting the results because it was an exploratory, underpowered study.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EARTS-HF\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eeplerenone\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Efinerenone\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eheart failure\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Emineralocorticoid receptor antagonists\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EN-terminal pro-brain natriuretic peptide\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENT-proBNP\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EGerasimos Filippatos, MD, Athens University Hospital Attikon, Athens, Greece, presented results of the ARTS-HF study [Pitt B et al. \u003Cem\u003EEur J Heart Fail\u003C\/em\u003E. 2015], demonstrating that finerenone was well tolerated and had a comparable efficacy with eplerenone in reducing N-terminal pro-brain natriuretic peptide (NT-proBNP) and a greater efficacy in reducing the incidence of the clinical composite end point of all-cause death, cardiovascular (CV) hospitalization, or emergency presentation for worsening chronic heart failure (CHF) in patients with heart failure with reduced ejection fraction (HFrEF).\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EMineralocorticoid receptor antagonists (MRA) such as spironolactone and eplerenone are recommended by treatment guidelines [Yancy CW et al. \u003Cem\u003ECirculation\u003C\/em\u003E. 2013; McMurray JJ et al. \u003Cem\u003EEur Heart J\u003C\/em\u003E. 2012], as they reduce mortality and hospitalizations in patients with HFrEF. However, they may be underused because of the fear of inducing hyperkalemia or worsening renal function in high-risk patients, and despite the current treatments, mortality and morbidity remains high, especially after hospitalization for worsening heart failure. Finerenone is a novel nonsteroidal MRA that has greater receptor selectivity than spironolactone and better receptor affinity than eplerenone in vitro.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EARTS-HF was a randomized, double-blind, active-comparator-controlled, multicenter, phase 2b dose-finding study with an objective to compare the safety and efficacy of different once-daily oral doses of finerenone with eplerenone in patients with worsening chronic HFrEF and type 2 diabetes or chronic kidney disease (CKD). The primary end point was the proportion of patients with a relative decrease in NT-proBNP of \u0026gt;\u200530% from baseline to day 90. The exploratory end points included the clinical composite end point of death from any cause, CV hospitalization, or emergency presentation for worsening CHF.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EA total of 1055 patients were enrolled and randomized to eplerenone (n\u2005=\u2005221) or to 5 different finerenone doses: 2.5 to 5 mg (n\u2005=\u2005172), 5 to 10 mg (n\u2005=\u2005163), 7.5 to 15 mg (n\u2005=\u2005167), 10 to 20 mg (n\u2005=\u2005169), and 15 to 20 mg (n\u2005=\u2005163). The percentage of patients who had an NT-proBNP decrease of \u0026gt;\u200530% at day 90 compared with baseline did not differ substantially between each treatment group, with reductions ranging from 30.9% to 38.8%.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe incidence of the exploratory clinical composite at day 90 was lower with all finerenone doses (except 2.5\u20135 mg) than with eplerenone, with the lowest incidence observed in the group treated with finerenone 10\u201320 mg. The risk of all-cause death was reduced more by finerenone 10\u201320 mg vs eplerenone (HR, 0.14; 95% CI, 0.02 to 1.07), and the risk of CV hospitalization was also lowered more significantly by finerenone 10\u201320 mg (HR, 0.56; 95% CI, 0.34 to 0.93). Health-related quality of life was improved comparably in all treatment groups.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThe incidence of any adverse event (AE), serious AEs, and AEs of special interest was similar in all treatment groups. The mean change in the potassium levels from baseline was statistically significantly lower with the 3 lowest finerenone doses compared with eplerenone.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EProf Filippatos concluded that in patients with HFrEF, finerenone had a comparable efficacy to eplerenone in reducing NT-proBNP and a greater efficacy in reducing the incidence of the clinical composite end point of all-cause death, CV hospitalization, or emergency presentation for worsening CHF.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EBayer says it plans to move ahead with phase 3 trials with finerenone, including a study called FINESSE-HF in more than 3000 HF patients with reduced ejection fraction and type 2 diabetes and\/or chronic kidney disease. It also plans to conduct the FIGARO-DKD and FIDELIO-DKD trials in patients with diabetic kidney disease.\u003C\/p\u003E\u003Cp id=\u0022p-10\u0022\u003E\u003Cem\u003EReviewer comment\u003C\/em\u003E: We need to be cautious in our interpretation of this underpowered exploratory trial. The overall dose response of finerenone is somewhat inconsistent.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/28\/16.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzl4ke\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}