Key Summary
- NICE recommends finerenone for adults with symptomatic chronic heart failure.
- In England, an estimated 635,000 people live with heart failure.
- NICE estimates that up to 280,000 people could be eligible to receive finerenone under this guidance.
The National Institute for Health and Care Excellence (NICE) has issued a final draft guidance that recommends finerenone (also called Kerendia and made by Bayer) for adults with symptomatic chronic heart failure with preserved or mildly reduced ejection fraction.
These happen when the left side of the heart doesn't fill properly with blood during the diastolic (filling) phase.
This means the heart is unable to pump enough blood to meet the body’s needs.
The decline in pumping capacity is generally less severe than in heart failure with reduced ejection fraction, but patients still commonly experience symptoms such as breathlessness, tiredness and swollen ankles.
People with preserved or mildly reduced ejection fraction often undergo repeated hospital stays, which harms quality of life and independence.
Usually developing gradually over time, chronic heart failure is often the result of a number of conditions including heart attack, coronary artery disease, atrial fibrillation and high blood pressure.
Many patients also have other long-term conditions - such as chronic kidney disease, diabetes or high blood pressure - which complicates treatment.
Finerenone belongs to the mineralocorticoid receptor antagonist (MRA) class; it is a nonsteroidal MRA, which may make it suitable for a broader group of patients than older steroidal MRAs.
Evidence shows that adding finerenone to usual care reduces the total number of worsening heart-failure events (including the need for people with heart failure to visit hospital urgently or having to stay in hospital) by around 18 percent compared with a placebo plus usual care.
Finerenone may also reduce the risk of dying from a cardiovascular event such as a heart attack or stroke, or other causes.
In England, an estimated 635,000 people live with heart failure, and around half of them have preserved or mildly reduced ejection fraction.
Heart failure was responsible for roughly 100,000 hospital admissions in 2023/24, making it a major contributor to preventable hospital stays.
About 25 percent of people with heart failure die within a year of diagnosis, and more than half within five years.
NICE estimates that up to 280,000 people could be eligible to receive finerenone under this guidance.
Helen Knight, director of medicines evaluation at NICE, said: “Heart failure can have a profound effect on people's daily lives, often leading to repeated hospital admissions and a reduced quality of life.
“We’re committed to bring the best care to people fast, while at the same time ensuring value for money for the taxpayer. Today’s draft guidance means there is a further effective treatment available on the NHS for people with this type of heart failure. Not only does finerenone have the potential to help them live well for longer, but it could also save the NHS money and free up space by reducing their risk of having to go to hospital for unplanned emergency treatment.”
