{ "release_id": "5dcd9b263fe17744", "id": "cardio:finerenone", "owner": "cardio", "kind": "drug", "slug": "finerenone", "name": "Finerenone", "aliases": [ "Finerenone" ], "atlases": [ "cardio" ], "summary_plain": "The medicine inside Kerendia. It is a pill that blocks the mineralocorticoid receptor and is not a steroid. In the FIDELIO-DKD trial it lowered the risk of kidney disease getting worse in people with chronic kidney disease and type 2 diabetes, and it caused more stopping of the medicine because of high potassium. In the FINEARTS-HF trial in people with heart failure and an ejection fraction of 40% or more, it lowered the rate of a combined outcome of worsening heart failure events and cardiovascular death, with more high potassium; cardiovascular death alone did not clearly differ.", "summary_technical": "RxNorm ingredient 2562811. A nonsteroidal, selective mineralocorticoid receptor antagonist. In FIDELIO-DKD the primary kidney outcome hazard ratio was 0.82 (95% CI 0.73 to 0.93). Hyperkalemia-related discontinuation was 2.3% on finerenone and 0.9% on placebo. RxClass lists finerenone under the mineralocorticoid receptor antagonist class, which this record links to. The heart-failure trial FINEARTS-HF is in a separate claim: the rate ratio for total worsening heart failure events and cardiovascular death was 0.84 (95% CI 0.74 to 0.95), with more hyperkalemia.", "editorial_state": "draft", "last_substantive_edit": "2026-10-14", "last_evidence_check": null, "next_review_due": null, "identifiers": [ { "scheme": "rxnorm", "value": "2562811", "normalized_value": "2562811", "match": "exact", "version": null, "label": null, "from_source": false } ], "navigation": { "cardio": { "system": [ "kidneys" ], "condition-area": [ "kidney-connections", "diabetes-and-metabolic-disease" ] } }, "payload": { "level": "substance", "mechanism": "A nonsteroidal, selective mineralocorticoid receptor antagonist." }, "content_digest": "cfbf4d795beb066c49211aba01574810bcb0d8fb8f150f523821327a535ba64c", "review": { "content_digest": "cfbf4d795beb066c49211aba01574810bcb0d8fb8f150f523821327a535ba64c", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "claims": [ { "release_id": "5dcd9b263fe17744", "id": "cardio:claim-ada-kdigo-2022-ns-mra-finerenone", "owner": "cardio", "subject_entity_id": "cardio:finerenone", "category": "recommendation", "statement": "The formal consensus statement of the ADA/KDIGO report names a drug class, not finerenone: it recommends a nonsteroidal mineralocorticoid receptor antagonist (ns-MRA) whose kidney and cardiovascular benefit has been proven, for people with type 2 diabetes, an eGFR of 25 mL/min/1.73 m2 or higher, a normal serum potassium and albuminuria (an albumin-to-creatinine ratio of 30 mg/g or more) despite the largest dose of a renin-angiotensin system (RAS) inhibitor that they can tolerate. The report names finerenone as the only ns-MRA with that proof and the only one approved anywhere to slow CKD progression and reduce cardiovascular events, and says adding finerenone is reasonable for people with type 2 diabetes who have persistent albuminuria despite standard treatment with glucose-lowering and blood pressure medicines.", "context": { "id": "cardio:ctx-ada-kdigo-2022-t2d-albuminuria-egfr-25-plus-normal-potassium", "label": "Adults with type 2 diabetes, albuminuria, an eGFR of 25 or more and normal potassium, on the highest tolerated RAS inhibitor dose (ADA/KDIGO 2022 consensus report)", "recipient": "adult", "population": "Adults with type 2 diabetes who have an estimated glomerular filtration rate (eGFR) of 25 mL/min/1.73 m2 or higher, a normal serum potassium and albuminuria (an albumin-to-creatinine ratio of 30 mg/g or more) despite taking the largest dose of a renin-angiotensin system (RAS) inhibitor that they can tolerate. The report speaks of adults and gives no age bounds.", "care_setting": "Not stated in the report.", "geography": "Not stated in the report (a joint report of a US association and an international kidney organization)", "life_stage_note": "Adults, as the report's introduction puts it (adults with diabetes and CKD); the report gives no age bounds", "life_stage_terms": null, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable (guidance context)", "eligibility": { "inclusion": [ "Type 2 diabetes with chronic kidney disease, the report's scope (albuminuria of this size meets its CKD definition)", "eGFR of 25 mL/min/1.73 m2 or higher", "Normal serum potassium", "Albuminuria (albumin-to-creatinine ratio of 30 mg/g or more) despite the maximum tolerated dose of a RAS inhibitor" ], "exclusion": [] } }, "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "The formal consensus statement names the class and does not name finerenone. This claim sits on finerenone because the report's text and its Figure 3 note name finerenone as the only ns-MRA that met the statement's proviso when the report was written, so a later ns-MRA is not covered. The report's text also names esaxerenone, another ns-MRA, and says it lowered blood pressure and albuminuria but lacks long-term studies with clinical end points. The report advises a potassium check 4 weeks after any dose change and regular checks during treatment, and gives dosing and potassium limits that are not recorded here. The report's trial counts and percentages for finerenone are not recorded; the FIDELIO-DKD claim of this atlas carries that trial's figures. Only the PubMed record and the PMC full text were read. The report is joint ADA and KDIGO guidance drawn from the two organizations' 2022 guidelines, not a trial result, and its consensus statements carry no class of recommendation or level of evidence (the report points to the two organizations' own documents for those). It dates from 2022, so later trials and approvals are not covered. Its licence allows educational, not-for-profit use of the unaltered work, so this atlas restates the statement in its own words. PubMed lists no correction to the report (checked 2026-10-15).", "editorial_state": "draft", "checked_at": "2026-10-15", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "ns-MRAs, Consensus Statement", "applicability_note": "The consensus statement on an ns-MRA.", "snapshot": { "id": "cardio:pmc-pmc9870667-2026-10-15", "retrieved_at": "2026-10-15T15:38:41Z", "content_hash": "18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:ada-kdigo-2022-consensus", "source_type": "guideline", "title": "Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)", "canonical_url": "https://doi.org/10.2337/dci22-0027", "identifiers": [ { "scheme": "doi", "value": "10.2337/dci22-0027", "normalized_value": "10.2337/dci22-0027", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "36189689", "normalized_value": "36189689", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmcid", "value": "PMC9870667", "normalized_value": "PMC9870667", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2022-12-01", "publisher": "Diabetes Care", "edition": "Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.", "reuse_basis": "PubMed record and PMC full text, fetched through NCBI E-utilities on 2026-10-15 (cib-pubmed-36189689.xml and cib-pmc-PMC9870667.xml). Only the hashes of the bytes are kept; nothing is committed. The PMC copy carries the American Diabetes Association's own licence, which permits use with a citation for teaching purposes without profit, provided the work is left unchanged. The publisher's licence page returned HTTP 403 to a script (cib-diabetesjournals-license.html) and was not worked around. The licence is not a Creative Commons licence and the atlas does not claim it is non-commercial in every use, so public text is cite_only: public pages restate the report in the atlas's own words, with a citation and a link, and show no quoted span. Quote rows are short evidence fragments for the reviewer.", "public_text": "cite_only" } }, { "evidence_role": "supports", "locator": "Goals of Comprehensive Care, Figure 3 note", "applicability_note": "Finerenone named as the only member of the class with proven benefit.", "snapshot": { "id": "cardio:pmc-pmc9870667-2026-10-15", "retrieved_at": "2026-10-15T15:38:41Z", "content_hash": "18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:ada-kdigo-2022-consensus", "source_type": "guideline", "title": "Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)", "canonical_url": "https://doi.org/10.2337/dci22-0027", "identifiers": [ { "scheme": "doi", "value": "10.2337/dci22-0027", "normalized_value": "10.2337/dci22-0027", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "36189689", "normalized_value": "36189689", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmcid", "value": "PMC9870667", "normalized_value": "PMC9870667", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2022-12-01", "publisher": "Diabetes Care", "edition": "Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.", "reuse_basis": "PubMed record and PMC full text, fetched through NCBI E-utilities on 2026-10-15 (cib-pubmed-36189689.xml and cib-pmc-PMC9870667.xml). Only the hashes of the bytes are kept; nothing is committed. The PMC copy carries the American Diabetes Association's own licence, which permits use with a citation for teaching purposes without profit, provided the work is left unchanged. The publisher's licence page returned HTTP 403 to a script (cib-diabetesjournals-license.html) and was not worked around. The licence is not a Creative Commons licence and the atlas does not claim it is non-commercial in every use, so public text is cite_only: public pages restate the report in the atlas's own words, with a citation and a link, and show no quoted span. Quote rows are short evidence fragments for the reviewer.", "public_text": "cite_only" } }, { "evidence_role": "supports", "locator": "ns-MRAs, para 2 (approval)", "applicability_note": "Finerenone named as the only approved drug of the class for slowing CKD progression.", "snapshot": { "id": "cardio:pmc-pmc9870667-2026-10-15", "retrieved_at": "2026-10-15T15:38:41Z", "content_hash": "18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:ada-kdigo-2022-consensus", "source_type": "guideline", "title": "Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)", "canonical_url": "https://doi.org/10.2337/dci22-0027", "identifiers": [ { "scheme": "doi", "value": "10.2337/dci22-0027", "normalized_value": "10.2337/dci22-0027", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "36189689", "normalized_value": "36189689", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmcid", "value": "PMC9870667", "normalized_value": "PMC9870667", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2022-12-01", "publisher": "Diabetes Care", "edition": "Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.", "reuse_basis": "PubMed record and PMC full text, fetched through NCBI E-utilities on 2026-10-15 (cib-pubmed-36189689.xml and cib-pmc-PMC9870667.xml). Only the hashes of the bytes are kept; nothing is committed. The PMC copy carries the American Diabetes Association's own licence, which permits use with a citation for teaching purposes without profit, provided the work is left unchanged. The publisher's licence page returned HTTP 403 to a script (cib-diabetesjournals-license.html) and was not worked around. The licence is not a Creative Commons licence and the atlas does not claim it is non-commercial in every use, so public text is cite_only: public pages restate the report in the atlas's own words, with a citation and a link, and show no quoted span. Quote rows are short evidence fragments for the reviewer.", "public_text": "cite_only" } }, { "evidence_role": "supports", "locator": "ns-MRAs, para 4 (adding finerenone)", "applicability_note": "Adding finerenone is called reasonable.", "snapshot": { "id": "cardio:pmc-pmc9870667-2026-10-15", "retrieved_at": "2026-10-15T15:38:41Z", "content_hash": "18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:ada-kdigo-2022-consensus", "source_type": "guideline", "title": "Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)", "canonical_url": "https://doi.org/10.2337/dci22-0027", "identifiers": [ { "scheme": "doi", "value": "10.2337/dci22-0027", "normalized_value": "10.2337/dci22-0027", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "36189689", "normalized_value": "36189689", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmcid", "value": "PMC9870667", "normalized_value": "PMC9870667", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2022-12-01", "publisher": "Diabetes Care", "edition": "Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.", "reuse_basis": "PubMed record and PMC full text, fetched through NCBI E-utilities on 2026-10-15 (cib-pubmed-36189689.xml and cib-pmc-PMC9870667.xml). Only the hashes of the bytes are kept; nothing is committed. The PMC copy carries the American Diabetes Association's own licence, which permits use with a citation for teaching purposes without profit, provided the work is left unchanged. The publisher's licence page returned HTTP 403 to a script (cib-diabetesjournals-license.html) and was not worked around. The licence is not a Creative Commons licence and the atlas does not claim it is non-commercial in every use, so public text is cite_only: public pages restate the report in the atlas's own words, with a citation and a link, and show no quoted span. Quote rows are short evidence fragments for the reviewer.", "public_text": "cite_only" } }, { "evidence_role": "supports", "locator": "ns-MRAs, para 5 (potassium monitoring)", "applicability_note": "Potassium monitoring.", "snapshot": { "id": "cardio:pmc-pmc9870667-2026-10-15", "retrieved_at": "2026-10-15T15:38:41Z", "content_hash": "18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:ada-kdigo-2022-consensus", "source_type": "guideline", "title": "Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)", "canonical_url": "https://doi.org/10.2337/dci22-0027", "identifiers": [ { "scheme": "doi", "value": "10.2337/dci22-0027", "normalized_value": "10.2337/dci22-0027", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "36189689", "normalized_value": "36189689", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmcid", "value": "PMC9870667", "normalized_value": "PMC9870667", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2022-12-01", "publisher": "Diabetes Care", "edition": "Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.", "reuse_basis": "PubMed record and PMC full text, fetched through NCBI E-utilities on 2026-10-15 (cib-pubmed-36189689.xml and cib-pmc-PMC9870667.xml). Only the hashes of the bytes are kept; nothing is committed. The PMC copy carries the American Diabetes Association's own licence, which permits use with a citation for teaching purposes without profit, provided the work is left unchanged. The publisher's licence page returned HTTP 403 to a script (cib-diabetesjournals-license.html) and was not worked around. The licence is not a Creative Commons licence and the atlas does not claim it is non-commercial in every use, so public text is cite_only: public pages restate the report in the atlas's own words, with a citation and a link, and show no quoted span. Quote rows are short evidence fragments for the reviewer.", "public_text": "cite_only" } }, { "evidence_role": "supports", "locator": "ns-MRAs, para 2 (esaxerenone)", "applicability_note": "Esaxerenone, another ns-MRA, lacks long-term end-point studies.", "snapshot": { "id": "cardio:pmc-pmc9870667-2026-10-15", "retrieved_at": "2026-10-15T15:38:41Z", "content_hash": "18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:ada-kdigo-2022-consensus", "source_type": "guideline", "title": "Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)", "canonical_url": "https://doi.org/10.2337/dci22-0027", "identifiers": [ { "scheme": "doi", "value": "10.2337/dci22-0027", "normalized_value": "10.2337/dci22-0027", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "36189689", "normalized_value": "36189689", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmcid", "value": "PMC9870667", "normalized_value": "PMC9870667", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2022-12-01", "publisher": "Diabetes Care", "edition": "Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.", "reuse_basis": "PubMed record and PMC full text, fetched through NCBI E-utilities on 2026-10-15 (cib-pubmed-36189689.xml and cib-pmc-PMC9870667.xml). Only the hashes of the bytes are kept; nothing is committed. The PMC copy carries the American Diabetes Association's own licence, which permits use with a citation for teaching purposes without profit, provided the work is left unchanged. The publisher's licence page returned HTTP 403 to a script (cib-diabetesjournals-license.html) and was not worked around. The licence is not a Creative Commons licence and the atlas does not claim it is non-commercial in every use, so public text is cite_only: public pages restate the report in the atlas's own words, with a citation and a link, and show no quoted span. Quote rows are short evidence fragments for the reviewer.", "public_text": "cite_only" } }, { "evidence_role": "context", "locator": "Introduction, para 4 (level of evidence)", "applicability_note": "The consensus statements carry no level of evidence.", "snapshot": { "id": "cardio:pmc-pmc9870667-2026-10-15", "retrieved_at": "2026-10-15T15:38:41Z", "content_hash": "18bc2637f4a3599a78fcf093fbd32cd604d294579ccd5970a51e0239e485aad7", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:ada-kdigo-2022-consensus", "source_type": "guideline", "title": "Diabetes Management in Chronic Kidney Disease: A Consensus Report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO)", "canonical_url": "https://doi.org/10.2337/dci22-0027", "identifiers": [ { "scheme": "doi", "value": "10.2337/dci22-0027", "normalized_value": "10.2337/dci22-0027", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "36189689", "normalized_value": "36189689", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmcid", "value": "PMC9870667", "normalized_value": "PMC9870667", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2022-12-01", "publisher": "Diabetes Care", "edition": "Published in Diabetes Care 45(12):3075-3090 (December 2022 issue; online 3 October 2022). PubMed record and the PMC full text (PMC9870667, in the PMC Open Access subset), both fetched 2026-10-15. PubMed lists no correction to the report. The same report was also published in Kidney International (PMID 36202661), which is not recorded as a separate source. The report is a joint consensus document that draws on the ADA Standards of Medical Care in Diabetes and the KDIGO 2022 guideline; it is a different document from either.", "reuse_basis": "PubMed record and PMC full text, fetched through NCBI E-utilities on 2026-10-15 (cib-pubmed-36189689.xml and cib-pmc-PMC9870667.xml). Only the hashes of the bytes are kept; nothing is committed. The PMC copy carries the American Diabetes Association's own licence, which permits use with a citation for teaching purposes without profit, provided the work is left unchanged. The publisher's licence page returned HTTP 403 to a script (cib-diabetesjournals-license.html) and was not worked around. The licence is not a Creative Commons licence and the atlas does not claim it is non-commercial in every use, so public text is cite_only: public pages restate the report in the atlas's own words, with a citation and a link, and show no quoted span. Quote rows are short evidence fragments for the reviewer.", "public_text": "cite_only" } } ], "review": { "content_digest": "4f2047a69d83ab73f7921246492f42eddf2c53497c9d27d08805ee208bc90b51", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "api_path": "api/v1/claims/cardio--claim-ada-kdigo-2022-ns-mra-finerenone.json" }, { "release_id": "5dcd9b263fe17744", "id": "cardio:claim-fidelio-dkd-kidney-effect", "owner": "cardio", "subject_entity_id": "cardio:finerenone", "category": "effect", "statement": "In FIDELIO-DKD, 5734 patients with chronic kidney disease and type 2 diabetes, all on maximum tolerated renin-angiotensin system blockade, were randomly assigned to finerenone or placebo. During a median follow-up of 2.6 years, the primary outcome (kidney failure, a sustained decrease of at least 40% in eGFR from baseline, or death from renal causes) occurred in 504 of 2833 patients (17.8%) on finerenone and 600 of 2841 (21.1%) on placebo (hazard ratio 0.82; 95% CI 0.73 to 0.93; P=0.001). The key secondary outcome (death from cardiovascular causes, nonfatal heart attack, nonfatal stroke or hospitalization for heart failure) occurred in 367 patients (13.0%) and 420 (14.8%) (hazard ratio 0.86; 95% CI 0.75 to 0.99; P=0.03). Overall adverse events were similar in the two groups, but stopping the trial regimen because of high potassium (hyperkalemia) was more frequent on finerenone, 2.3% against 0.9%.", "context": { "id": "cardio:ctx-fidelio-adults-type-2-diabetes-ckd", "label": "Adults with chronic kidney disease and type 2 diabetes (FIDELIO-DKD)", "recipient": "adult", "population": "Patients with chronic kidney disease and type 2 diabetes who had a urinary albumin-to-creatinine ratio of 30 to below 300, an eGFR of 25 to below 60 and diabetic retinopathy, or a ratio of 300 to 5000 and an eGFR of 25 to below 75. All were treated with renin-angiotensin system blockade adjusted to the maximum label dose they tolerated.", "care_setting": "Multicenter trial. The care setting is not described further in the sources read.", "geography": "Multinational. The registry lists the sites by country on the study page.", "life_stage_note": "Adults aged 18 years or older (registry minimum age 18 years)", "life_stage_terms": null, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Median follow-up 2.6 years.", "eligibility": { "inclusion": [ "Chronic kidney disease and type 2 diabetes", "Albumin-to-creatinine ratio 30 to below 300, eGFR 25 to below 60 and diabetic retinopathy; or ratio 300 to 5000 and eGFR 25 to below 75", "Renin-angiotensin system blockade at the maximum tolerated label dose" ], "exclusion": [] } }, "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "Participants had to be on renin-angiotensin system blockade and had diabetic kidney disease, so the result does not cover people without diabetes or without that blockade. Funded by Bayer (named in the abstract). Only the PubMed abstract was read.", "editorial_state": "draft", "checked_at": "2026-10-14", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, RESULTS, sentence 1", "applicability_note": "Primary outcome events by arm, hazard ratio and p-value.", "snapshot": { "id": "cardio:pubmed-33264825-2026-10-14", "retrieved_at": "2026-10-14T18:18:49Z", "content_hash": "aa1851e07117283e5bda4286fa413399c6767f2e4854a017e0ea917d59982a1d", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2025845", "source_type": "publication", "title": "Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes", "canonical_url": "https://doi.org/10.1056/NEJMoa2025845", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2025845", "normalized_value": "10.1056/nejmoa2025845", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "33264825", "normalized_value": "33264825", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2020-12-03", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } }, { "evidence_role": "supports", "locator": "Abstract, RESULTS, sentence 2", "applicability_note": "Key secondary outcome.", "snapshot": { "id": "cardio:pubmed-33264825-2026-10-14", "retrieved_at": "2026-10-14T18:18:49Z", "content_hash": "aa1851e07117283e5bda4286fa413399c6767f2e4854a017e0ea917d59982a1d", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2025845", "source_type": "publication", "title": "Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes", "canonical_url": "https://doi.org/10.1056/NEJMoa2025845", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2025845", "normalized_value": "10.1056/nejmoa2025845", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "33264825", "normalized_value": "33264825", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2020-12-03", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } }, { "evidence_role": "supports", "locator": "Abstract, RESULTS, sentence 3; Abstract, RESULTS, sentence 4", "applicability_note": "Adverse events overall and hyperkalemia-related discontinuation.", "snapshot": { "id": "cardio:pubmed-33264825-2026-10-14", "retrieved_at": "2026-10-14T18:18:49Z", "content_hash": "aa1851e07117283e5bda4286fa413399c6767f2e4854a017e0ea917d59982a1d", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2025845", "source_type": "publication", "title": "Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes", "canonical_url": "https://doi.org/10.1056/NEJMoa2025845", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2025845", "normalized_value": "10.1056/nejmoa2025845", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "33264825", "normalized_value": "33264825", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2020-12-03", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } }, { "evidence_role": "supports", "locator": "Abstract, CONCLUSIONS, sentence 1", "applicability_note": "The authors conclusion.", "snapshot": { "id": "cardio:pubmed-33264825-2026-10-14", "retrieved_at": "2026-10-14T18:18:49Z", "content_hash": "aa1851e07117283e5bda4286fa413399c6767f2e4854a017e0ea917d59982a1d", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2025845", "source_type": "publication", "title": "Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes", "canonical_url": "https://doi.org/10.1056/NEJMoa2025845", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2025845", "normalized_value": "10.1056/nejmoa2025845", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "33264825", "normalized_value": "33264825", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2020-12-03", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } }, { "evidence_role": "context", "locator": "Abstract, BACKGROUND, sentence 1; Abstract, METHODS, sentence 4; Abstract, METHODS, sentence 5", "applicability_note": "What finerenone is, and the primary and key secondary outcome definitions.", "snapshot": { "id": "cardio:pubmed-33264825-2026-10-14", "retrieved_at": "2026-10-14T18:18:49Z", "content_hash": "aa1851e07117283e5bda4286fa413399c6767f2e4854a017e0ea917d59982a1d", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2025845", "source_type": "publication", "title": "Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes", "canonical_url": "https://doi.org/10.1056/NEJMoa2025845", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2025845", "normalized_value": "10.1056/nejmoa2025845", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "33264825", "normalized_value": "33264825", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2020-12-03", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } }, { "evidence_role": "context", "locator": "Abstract, CONCLUSIONS, sentence 2", "applicability_note": "Funding line.", "snapshot": { "id": "cardio:pubmed-33264825-2026-10-14", "retrieved_at": "2026-10-14T18:18:49Z", "content_hash": "aa1851e07117283e5bda4286fa413399c6767f2e4854a017e0ea917d59982a1d", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2025845", "source_type": "publication", "title": "Effect of Finerenone on Chronic Kidney Disease Outcomes in Type 2 Diabetes", "canonical_url": "https://doi.org/10.1056/NEJMoa2025845", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2025845", "normalized_value": "10.1056/nejmoa2025845", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "33264825", "normalized_value": "33264825", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2020-12-03", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } } ], "review": { "content_digest": "138e55dde6898677af70cd85430254ff2b7540779384394c28d9e1d12ab0320e", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "api_path": "api/v1/claims/cardio--claim-fidelio-dkd-kidney-effect.json" }, { "release_id": "5dcd9b263fe17744", "id": "cardio:claim-finearts-hf-primary-effect", "owner": "cardio", "subject_entity_id": "cardio:finerenone", "category": "effect", "statement": "In FINEARTS-HF, patients with heart failure and a left ventricular ejection fraction of 40% or greater were randomly assigned, in a 1:1 ratio, to finerenone or matching placebo, each on top of usual therapy; the finerenone dose was titrated to a maximum of 20 mg or 40 mg once daily. The primary outcome counted two things together: total worsening heart failure events (first or repeat unplanned hospitalizations or urgent visits for heart failure) and death from cardiovascular causes. Over a median follow-up of 32 months, 1083 primary-outcome events occurred in 624 of 3003 patients on finerenone and 1283 events in 719 of 2998 patients on placebo (rate ratio 0.84; 95% CI 0.74 to 0.95; P=0.007). Worsening heart failure events alone numbered 842 on finerenone and 1024 on placebo (rate ratio 0.82; 95% CI 0.71 to 0.94; P=0.006). Death from cardiovascular causes occurred in 8.1% and 8.7% of patients (hazard ratio 0.93; 95% CI 0.78 to 1.11), an interval that includes 1. Finerenone was associated with more hyperkalemia and less hypokalemia.", "context": { "id": "cardio:ctx-finearts-hf-lvef-40-or-more", "label": "Patients with heart failure and an ejection fraction of 40% or greater (FINEARTS-HF)", "recipient": "unknown", "population": "Patients with heart failure and a left ventricular ejection fraction of 40% or greater, which covers mildly reduced and preserved ejection fraction.", "care_setting": "International, double-blind, randomized trial; the abstract does not describe the care setting further.", "geography": "International, according to the abstract. The countries were not read.", "life_stage_note": "Not stated in the abstract.", "life_stage_terms": null, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Median follow-up 32 months.", "eligibility": { "inclusion": [ "Heart failure", "Left ventricular ejection fraction of 40% or greater" ], "exclusion": [] } }, "evidence_stage": "interventional", "certainty": "not_assessed", "certainty_method": null, "limitations": "One double-blind trial, funded by Bayer (named in the abstract). Only the PubMed abstract was read, not the full paper, and the registry record the abstract names (NCT04435626) was not read. The abstract gives no age limits and no certainty grade. The primary outcome is a composite. Total worsening heart failure events alone were also lower, while for cardiovascular death alone the confidence interval included 1. The abstract gives no size for the hyperkalemia and hypokalemia findings. The ejection fraction band of 40% or greater covers the mildly reduced and the preserved range, and it includes 40% itself, which NHLBI counts in the reduced range, so the result is not specific to the mildly reduced or the preserved type.", "editorial_state": "draft", "checked_at": "2026-10-14", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Abstract, RESULTS, sentence 1", "applicability_note": "Primary-outcome events and patients by arm, rate ratio and p-value.", "snapshot": { "id": "cardio:pubmed-39225278-2026-10-14", "retrieved_at": "2026-10-14T18:18:51Z", "content_hash": "a5952811b7ff90f593b834a08399a1df3ec77ced0ca460a95a593c31d9a9922b", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2407107", "source_type": "publication", "title": "Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction", "canonical_url": "https://doi.org/10.1056/NEJMoa2407107", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2407107", "normalized_value": "10.1056/nejmoa2407107", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "39225278", "normalized_value": "39225278", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2024-10-24", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. PubMed lists commentary on the paper and no correction.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } }, { "evidence_role": "supports", "locator": "Abstract, RESULTS, sentence 2", "applicability_note": "Total worsening heart failure events.", "snapshot": { "id": "cardio:pubmed-39225278-2026-10-14", "retrieved_at": "2026-10-14T18:18:51Z", "content_hash": "a5952811b7ff90f593b834a08399a1df3ec77ced0ca460a95a593c31d9a9922b", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2407107", "source_type": "publication", "title": "Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction", "canonical_url": "https://doi.org/10.1056/NEJMoa2407107", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2407107", "normalized_value": "10.1056/nejmoa2407107", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "39225278", "normalized_value": "39225278", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2024-10-24", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. PubMed lists commentary on the paper and no correction.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } }, { "evidence_role": "supports", "locator": "Abstract, RESULTS, sentence 3; Abstract, RESULTS, sentence 4", "applicability_note": "Cardiovascular death and potassium findings.", "snapshot": { "id": "cardio:pubmed-39225278-2026-10-14", "retrieved_at": "2026-10-14T18:18:51Z", "content_hash": "a5952811b7ff90f593b834a08399a1df3ec77ced0ca460a95a593c31d9a9922b", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2407107", "source_type": "publication", "title": "Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction", "canonical_url": "https://doi.org/10.1056/NEJMoa2407107", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2407107", "normalized_value": "10.1056/nejmoa2407107", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "39225278", "normalized_value": "39225278", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2024-10-24", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. PubMed lists commentary on the paper and no correction.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } }, { "evidence_role": "supports", "locator": "Abstract, CONCLUSIONS, sentence 1", "applicability_note": "The authors conclusion.", "snapshot": { "id": "cardio:pubmed-39225278-2026-10-14", "retrieved_at": "2026-10-14T18:18:51Z", "content_hash": "a5952811b7ff90f593b834a08399a1df3ec77ced0ca460a95a593c31d9a9922b", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2407107", "source_type": "publication", "title": "Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction", "canonical_url": "https://doi.org/10.1056/NEJMoa2407107", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2407107", "normalized_value": "10.1056/nejmoa2407107", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "39225278", "normalized_value": "39225278", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2024-10-24", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. PubMed lists commentary on the paper and no correction.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } }, { "evidence_role": "context", "locator": "Abstract, METHODS, sentence 1; Abstract, METHODS, sentence 2", "applicability_note": "Population, doses and the primary outcome definition.", "snapshot": { "id": "cardio:pubmed-39225278-2026-10-14", "retrieved_at": "2026-10-14T18:18:51Z", "content_hash": "a5952811b7ff90f593b834a08399a1df3ec77ced0ca460a95a593c31d9a9922b", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2407107", "source_type": "publication", "title": "Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction", "canonical_url": "https://doi.org/10.1056/NEJMoa2407107", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2407107", "normalized_value": "10.1056/nejmoa2407107", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "39225278", "normalized_value": "39225278", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2024-10-24", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. PubMed lists commentary on the paper and no correction.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } }, { "evidence_role": "context", "locator": "Abstract, CONCLUSIONS, sentence 2", "applicability_note": "Funding line.", "snapshot": { "id": "cardio:pubmed-39225278-2026-10-14", "retrieved_at": "2026-10-14T18:18:51Z", "content_hash": "a5952811b7ff90f593b834a08399a1df3ec77ced0ca460a95a593c31d9a9922b", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "cardio:pubmed-10-1056-nejmoa2407107", "source_type": "publication", "title": "Finerenone in Heart Failure with Mildly Reduced or Preserved Ejection Fraction", "canonical_url": "https://doi.org/10.1056/NEJMoa2407107", "identifiers": [ { "scheme": "doi", "value": "10.1056/NEJMoa2407107", "normalized_value": "10.1056/nejmoa2407107", "match": "exact", "version": null, "label": null, "from_source": false }, { "scheme": "pmid", "value": "39225278", "normalized_value": "39225278", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2024-10-24", "publisher": "The New England journal of medicine", "edition": "PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched. PubMed lists commentary on the paper and no correction.", "reuse_basis": "PubMed record fetched through NCBI E-utilities. Only the hash of the bytes is kept, because publisher copyright may apply to the abstract (https://pubmed.ncbi.nlm.nih.gov/disclaimer/). Short factual quotations under 25 words, with the citation.", "public_text": "quote" } } ], "review": { "content_digest": "bcb56b9b4cf18117d1c8c85a13d724a6dd5aea6c4725a8515b82d77d3ba09bc3", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "api_path": "api/v1/claims/cardio--claim-finearts-hf-primary-effect.json" } ], "decisions": [ { "type": "recommendation", "id": "cardio:rec-ada-kdigo-2022-ns-mra", "direction": "for", "intervention_id": "cardio:finerenone", "context_id": "cardio:ctx-ada-kdigo-2022-t2d-albuminuria-egfr-25-plus-normal-potassium", "guideline_snapshot_id": "cardio:pmc-pmc9870667-2026-10-15", "guideline_id": "cardio:guideline-ada-kdigo-2022-consensus", "issuer_id": "cardio:kdigo", "jurisdictions": [ "not_stated" ], "jurisdiction_note": "A joint report of a US association and an international kidney organization; the report names no jurisdiction. Only one of the two issuers can be recorded here; the guideline record lists both.", "strength_label": "Consensus statement; the report prints no class of recommendation", "strength_system": "The report prints no class or level of evidence for its consensus statements, so none is recorded.", "effective_date": "2022-12", "effective_date_note": "The December 2022 issue of Diabetes Care, as PubMed gives it; the report was published online on 3 October 2022.", "superseded_by": null, "supersession_status": "not_checked", "claim_id": "cardio:claim-ada-kdigo-2022-ns-mra-finerenone" } ], "milestones": [], "relationships": { "outgoing": [ { "predicate": "evaluated_for", "label": "FIDELIO-DKD looked at kidney failure, eGFR decline and renal death in people with type 2 diabetes", "clinical_claim_not_fact": true, "family": "clinical", "other_entity_id": "cardio:chronic-kidney-disease", "other_entity_in_atlas": true, "claim_id": "cardio:claim-fidelio-dkd-kidney-effect", "evidence": null, "primary": false, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "subtype_of", "label": "Finerenone is a mineralocorticoid receptor antagonist (FDA mechanism-of-action class in RxClass)", "clinical_claim_not_fact": false, "family": "sourced", "other_entity_id": "cardio:mineralocorticoid-receptor-antagonists", "other_entity_in_atlas": true, "claim_id": null, "evidence": { "snapshot_id": "cardio:rxclass-2562811-2026-10-14", "locator": "rxclassDrugInfoList.rxclassDrugInfo[0].rxclassMinConceptItem.className" }, "primary": true, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "evaluated_for", "label": "FINEARTS-HF: lower rate of the combined outcome of worsening heart failure events and cardiovascular death than placebo, with more hyperkalemia", "clinical_claim_not_fact": true, "family": "clinical", "other_entity_id": "cardio:hfpef", "other_entity_in_atlas": true, "claim_id": "cardio:claim-finearts-hf-primary-effect", "evidence": null, "primary": false, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "part_of", "label": "Filed under this front", "clinical_claim_not_fact": false, "family": "navigation", "other_entity_id": "cardio:front-kidney-and-metabolic-care", "other_entity_in_atlas": true, "claim_id": null, "evidence": null, "primary": true, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "recommended_for", "label": "ADA/KDIGO 2022 consensus report, whose formal statement names the drug class (a nonsteroidal MRA), not finerenone: adults with type 2 diabetes and albuminuria, an eGFR of 25 or more and normal potassium despite the largest tolerated RAS inhibitor dose", "clinical_claim_not_fact": true, "family": "clinical", "other_entity_id": "cardio:chronic-kidney-disease", "other_entity_in_atlas": true, "claim_id": "cardio:claim-ada-kdigo-2022-ns-mra-finerenone", "evidence": null, "primary": false, "role": null, "valid_from": null, "valid_to": null } ], "incoming": [ { "predicate": "related_to", "label": "Related to", "clinical_claim_not_fact": false, "family": "navigation", "other_entity_id": "cardio:pathway-ckd-type-2-diabetes", "other_entity_in_atlas": true, "claim_id": null, "evidence": null, "primary": false, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "contains", "label": "Contained in", "clinical_claim_not_fact": false, "family": "sourced", "other_entity_id": "cardio:kerendia", "other_entity_in_atlas": true, "claim_id": null, "evidence": { "snapshot_id": "cardio:openfda-nda215341-2026-10-14", "locator": "results[0].products[0].active_ingredients[0].name" }, "primary": false, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "investigates", "label": "Investigated in", "clinical_claim_not_fact": false, "family": "sourced", "other_entity_id": "cardio:fidelio-dkd", "other_entity_in_atlas": true, "claim_id": null, "evidence": { "snapshot_id": "cardio:ctgov-nct02540993-2026-10-14", "locator": "protocolSection.armsInterventionsModule.interventions[0].name" }, "primary": false, "role": null, "valid_from": null, "valid_to": null } ] }, "page_path": "drugs/finerenone/", "context_path": "api/v1/context/cardio--finerenone.md" }