Safety profile of Finerenone: Pooled analysis of different types of arrhythmic events

Finerenone reduces kidney and cardiovascular events in patients with chronic kidney disease and type 2 diabetes mellitus, but its safety profile in terms of arrhythmic outcomes remains uncertain.

We systematically searched PubMed, Cochrane Library, and ClinicalTrials.gov (inception-March 2026) for randomized trials reporting arrhythmias or conduction disorders with finerenone versus control. Risk ratios (RRs) were pooled using fixed-effects models; heterogeneity was assessed with I².

Six trials (21,015 patients; mean age 67.2 years; 33.9% women) were included. Finerenone was not associated with increased atrial or ventricular arrhythmias, high-grade atrioventricular block, or cardiac arrest (all RRs non-significant; low heterogeneity).

Finerenone shows no clear increase in clinically reported arrhythmic events in the pooled analysis; however, the included studies were not designed to assess the rate of arrhythmic outcomes and might have underestimated the true rates.