Finerenone is a novel selective nonsteroidal mineralocorticoid receptor 
antagonist. Results in preclinical studies showed that lower doses of finerenone 
were needed to achieve similar cardiorenal protective effects compared to both 
spironolactone and eplerenone and phase II studies in finerenone in patients 
with heart failure, type-2 diabetes mellitus and/or chronic kidney disease are 
encouraging as the drug is effective and safe in patients on renin-angiotensin 
system inhibitors (significant reduction in albuminuria and a low rate of 
hyperkalemia), but the primary end points were "soft" end points (serum 
potassium, estimated glomerular filtration rate, albuminuria, N-terminal 
prohormone B-type natriuretic peptide levels). Thus, further, large-scale, 
long-term phase III trials are needed to confirm whether the greater affinity 
and selectivity is translated into improved clinical outcomes.