Gary

Routine visit with symptoms

Not a real patient.

Lily

Discharged after first HF hospitalization

Not a real patient.

Armand

Urgent visit due to symptoms

Not a real patient.

For your adult patients with HF LVEF ≥40%

Protect your patients from the risk of HF hospitalization, urgent HF visits, and CV death

Every patient touchpoint is an opportunity to start KERENDIA

Even with current treatments, including SGLT2is

Gary presented with symptoms during his routine visit for HFpEF management

Gary, 73 years old

An increase in loop diuretic dosage is being considered

Medical History

HFpEF: Diagnosed 1 year ago and initiated on an SGLT2i and a loop diuretic

Comorbidities

Hypertension
CKD

Current therapies

ARB
Loop diuretic
SGLT2i

Current labs/imaging

eGFR: 49 mL/min/1.73 m2
UACR: 210 mg/g
Serum potassium: 4.4 mEq/L
Echo: LVEF 50%

Patients like Gary with both HFpEF and CKD are at ~2x greater risk of having an HF event compared to those with HFpEF alone*

Even with current treatments, including SGLT2is

Lily recently experienced her first HF hospitalization following her HFmrEF diagnosis

Lily, 68 years old

She is following up today to discuss her options to reduce the risk of another HF hospitalization

Medical History

Diagnosed 3 months ago and initiated on an SGLT2i
HF hospitalization last week due to dyspnea, rapid weight gain, and edema
Increased loop diuretic dosage while hospitalized

Comorbidities

Hypertension
CKD

Current therapies

ARB
Beta-blocker
Loop diuretic
SGLT2i

Current labs/imaging

eGFR: 58 mL/min/1.73 m2
Serum potassium: 4.8 mEq/L
Echo: LVEF 45%

1 in 4 patients like Lily will be hospitalized due to HF within 1 year of discharge*

Even with current treatments, including SGLT2is

Armand scheduled an urgent visit due to symptoms caused by his HFpEF diagnosis

Armand, 73 years old

An increase in loop diuretic dosage is being considered

Medical History

HFpEF: Diagnosed 2 years ago and initiated on an SGLT2i and a loop diuretic

Comorbidities

Hypertension

Current therapies

ARB
Loop diuretic
SGLT2i

Current labs/imaging

eGFR: 65 mL/min/1.73 m2
Serum potassium: 4.4 mEq/L
Echo: LVEF 50%

Patients like Gary with both HFpEF and CKD are at ~2x greater risk of having an HF event compared to those with HFpEF alone*

ARB=angiotensin receptor blocker; CV=cardiovascular; eGFR=estimated glomerular filtration rate; HF=heart failure; HF LVEF=heart failure with left ventricular ejection fraction; HFpEF=heart failure with preserved ejection fraction; LVEF=left ventricular ejection fraction; SGLT2i=sodium-glucose cotransporter 2 inhibitor.

*Based on patients with HF LVEF >40% in a pivotal SGLT2i trial whose first presentation manifested as an outpatient oral diuretic intensification over a median of 2.3 years (n=789).

IMPORTANT SAFETY INFORMATION AND INDICATIONS

CONTRAINDICATIONS:

Hypersensitivity to any component of this product
Concomitant use with strong CYP3A4 inhibitors
Patients with adrenal insufficiency

WARNINGS AND PRECAUTIONS:

Hyperkalemia: KERENDIA can cause hyperkalemia. The risk for developing hyperkalemia increases with decreasing kidney function and is greater in patients with higher baseline potassium levels or other risk factors for hyperkalemia

Measure serum potassium and eGFR in all patients before initiation of treatment with KERENDIA and dose accordingly. Do not initiate KERENDIA if serum potassium is >5 mEq/L. Measure serum potassium periodically during treatment with KERENDIA and adjust dose accordingly. More frequent monitoring may be necessary for patients at risk for hyperkalemia, including those on concomitant medications that impair potassium excretion or increase serum potassium.
Worsening of Renal Function in Patients with Heart Failure: KERENDIA can cause worsening of renal function in patients with heart failure. Rarely, severe events associated with worsening renal function, including events requiring hospitalization, have been observed

Measure eGFR in all patients before initiation of treatment or with dose titration of KERENDIA and dose accordingly. Initiation of KERENDIA in patients with heart failure and an eGFR <25 mL/min/1.73 m² is not recommended. Measure eGFR periodically during maintenance treatment with KERENDIA in patients with heart failure. Consider delaying up-titration or interrupting treatment with KERENDIA in patients who develop clinically significant worsening of renal function

MOST COMMON ADVERSE REACTIONS:

CKD associated with T2D: From the pooled data of FIDELIO-DKD and FIGARO-DKD, the adverse reactions reported in ≥1% of patients on KERENDIA and more frequently than placebo were hyperkalemia (14% vs 6.9%), hypotension (4.6% vs 3%), and hyponatremia (1.3% vs 0.7%).
HF LVEF ≥40%: From FINEARTS-HF, the adverse reactions reported in ≥1% of patients on KERENDIA and more frequently than placebo were hyperkalemia (9.7% vs 4.2%), hypotension (7.6% vs 4.7%), and hyponatremia (1.9% vs 0.9%). Events related to worsening renal function were reported more frequently in the KERENDIA group (18%) compared with placebo (12%).

DRUG INTERACTIONS:

Strong CYP3A4 Inhibitors: Concomitant use of KERENDIA with strong CYP3A4 inhibitors is contraindicated. Avoid concomitant intake of grapefruit or grapefruit juice.
Moderate and Weak CYP3A4 Inhibitors: Monitor serum potassium during drug initiation or dosage adjustment of either KERENDIA or the moderate or weak CYP3A4 inhibitor, and adjust KERENDIA dosage as appropriate.
Strong and Moderate CYP3A4 Inducers: Avoid concomitant use of KERENDIA with strong or moderate CYP3A4 inducers.
Sensitive CYP2C8 Substrates at KERENDIA 40mg: Monitor patients more frequently for adverse reactions caused by sensitive CYP2C8 substrates if KERENDIA 40mg is co-administered with such substrates, since minimal concentration changes may lead to serious adverse reactions.

USE IN SPECIFIC POPULATIONS:

Lactation: Avoid breastfeeding during treatment with KERENDIA and for 1 day after treatment.
Hepatic Impairment: Avoid use of KERENDIA in patients with severe hepatic impairment (Child Pugh C) and consider additional serum potassium monitoring with moderate hepatic impairment (Child Pugh B).

INDICATIONS:

KERENDIA (finerenone) is indicated to reduce the risk of:

sustained estimated glomerular filtration rate (eGFR) decline, end-stage kidney disease, cardiovascular death, non-fatal myocardial infarction, and hospitalization for heart failure in adult patients with chronic kidney disease (CKD) associated with type 2 diabetes (T2D) (10mg, 20mg tablets)
cardiovascular death, hospitalization for heart failure, and urgent heart failure visits in adult patients with heart failure with left ventricular ejection fraction (HF LVEF) ≥40% (10mg, 20mg, 40mg tablets)

Please see the full Prescribing Information for KERENDIA.

REFERENCES

Routine visit with symptoms

Discharged after first HF hospitalization

Urgent visit due to symptoms

Protect your patients from the risk of HF hospitalization, urgent HF visits, and CV death

Gary presented with symptoms during his routine visit for HFpEF management

Gary, 73 years old

An increase in loop diuretic dosage is being considered

Medical History

Comorbidities

Current therapies

Current labs/imaging

Lily recently experienced her first HF hospitalization following her HFmrEF diagnosis

Lily, 68 years old

She is following up today to discuss her options to reduce the risk of another HF hospitalization

Medical History

Comorbidities

Current therapies

Current labs/imaging

Armand scheduled an urgent visit due to symptoms caused by his HFpEF diagnosis

Armand, 73 years old

An increase in loop diuretic dosage is being considered

Medical History

Comorbidities

Current therapies

Current labs/imaging