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Feature|Articles|October 16, 2026
Finerenone in Heart Failure: Evidence and Practice a Year Later
Author(s)Luke Halpern, Associate Editor
A year after FDA approval in heart failure (HF) with LVEF of 40% or higher, new ACC guidance and trial subanalyses are shaping how pharmacists use finerenone.
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More than a year after the FDA approved finerenone (Kerendia; Bayer) for adults with heart failure (HF) and a left ventricular ejection fraction (LVEF) of 40% or higher, the nonsteroidal mineralocorticoid receptor antagonist (MRA) has moved from new indication to recommended backbone therapy. The 2026 American College of Cardiology (ACC) Expert Consensus Decision Pathway (ECDP) for HF with preserved ejection fraction (HFpEF) states that finerenone “should be considered the MRA of choice for individuals with HFpEF,” and a review of the pathway describes nonsteroidal MRA therapy and sodium-glucose cotransporter 2 (SGLT2) inhibition as foundational treatment when not contraindicated.1-3
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