Role of Finerenone in Duchenne Muscular Dystrophy in a 45-Year-Old Man: Outcome and Brief Review.

BackgroundDuchenne muscular dystrophy (DMD) is an X-linked neuromuscular disorder characterized by the absence of dystrophin, leading to progressive skeletal and cardiac muscle degeneration. Cardiomyopathy is a leading cause of morbidity and mortality in patients with DMD, often manifesting as a dilated cardiomyopathy with myocardial fibrosis and arrhythmia. Mineralocorticoid receptor antagonists, including the nonsteroidal agent finerenone, have emerged as disease-modifying therapies because of their antifibrotic, anti-inflammatory, and cardioprotective properties.Case summaryA 45-year-old man with DMD and progressive nonischemic cardiomyopathy was initiated on finerenone in addition to guideline-directed medical therapy. Over 16 months, he demonstrated improvement in left ventricular ejection fraction and ventricular remodeling without adverse effects.DiscussionFinerenone is a nonsteroidal mineralocorticoid receptor antagonist with potent antifibrotic and anti-inflammatory properties. This case highlights its potential role in DMD cardiomyopathy, where fibrosis is central to disease progression.Take-home messageFinerenone may represent a novel therapy in DMD-associated cardiomyopathy and warrants further investigation for use in this population.