Dapagliflozin, which is already used to treat type-2 diabetes (T2D) and prevent development of heart failure, can also be used to treat pre-existing heart failure—even in patients without T2D, new research shows. The study was presented at the annual meeting of the European Association for the Study of Diabetes in Barcelona, Spain, and simultaneously published in The New England Journal of Medicine.
“The most important finding of all is the benefit in patients without diabetes. This shows dapagliflozin is truly a treatment for heart failure and not just a drug for diabetes,” says John McMurray, Professor of Cardiology at the Institute of Cardiovascular and Medical Sciences at the University of Glasgow, Scotland, who conducted the study with colleagues.
Dapagliflozin is a sodium-glucose cotransporter 2 inhibitor. Previous studies have shown that these drugs not only help control blood sugar levels, but can also improve cardiovascular outcomes, including promoting weight loss, reducing blood pressure, and reducing the risk of cardiovascular mortality.
Dapagliflozin has already been proven to reduce the risk of developing heart failure in T2D patients. In this new study, investigators analyzed whether the drug could also be used to treat patients with T2D in whom heart failure had already developed, and also heart failure in patients without T2D.
The DAPA-HF study enrolled 4,744 patients with heart failure in 20 countries; 45% had T2D and 55% did not. Patients were randomly allocated to either dapagliflozin 10 mg once daily or placebo. The primary endpoint was a combination of a first episode of worsening heart failure (hospitalization for heart failure or an urgent heart failure visit requiring intravenous therapy) or death from cardiovascular causes. These treatments were given on top of standard care.
Over a median follow-up of 18.2 months, the primary outcome occurred in 386 of 2,373 patients (16.3%) in the dapagliflozin group and in 502 of 2,371 patients (21.2%) in the placebo group, translating to a 26% reduced risk in the dapagliflozin group. The results were similar in the groups with and without T2D.
Source: Diabetologia, September 19, 2019
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