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Finerenone Prescriptions in the US (2021-2024) by Physician Specialty: Analysis of Use and Potential in the CKM Space

Jelwan Y, Cao T, Yao Z, Burka S, Erharbor J, Berning P, Dzaye O, Blaha M

2025

Abstract

Introduction: Finerenone, a non-steroidal mineralocorticoid receptor antagonist (MRA), has demonstrated greater receptor selectivity and fewer side effects compared to older mineralocorticoid receptor antagonists. Clinical trials support its efficacy in reducing kidney disease progression, cardiovascular events, and heart failure outcomes across various patient populations, however, anecdotally, the drug appears infrequently utilized in clinical practice.

Methods: A serial, cross-sectional analysis of IQVIA’s National Prescription Audit (NPA), which covers over 70% of U.S. outpatient prescription activity, was conducted from July 2021 to December 2024 to examine finerenone prescribing trends focusing on cardiologists and nephrologists. For added context, prescription rates of finerenone were compared to those of two other medications with related mechanisms or indications commonly used in Cardiovascular-Kidney-Metabolic (CKM) syndrome, spironolactone and empagliflozin. Prescribing trends were correlated with total search activity using Google Trends.

Results: We found that finerenone was prescribed at a rate of 30,180 prescriptions/month in December 2022, increasing to 45,420 in December 2023, and 60,756 prescriptions/month in December 2024. This modest increase correlated with changes in Google search activity, with mild inflections after the release of major clinical trial data. The ratio of total prescriptions from nephrologists (15.81 prescriptions per nephrologist) to…

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Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.

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