Tag Archives: dapagliflozin

Introduction Heart failure with reduced ejection fraction (HFrEF) is a significant healthcare burden internationally, with an age-standardised prevalence of approximately 3.8% in women and 4.6% in men, and an estimated five-year mortality rate of 43%.1,2 Hospitalisations for heart failure exacerbations represent a major financial challenge to health services, and such patients have a higher risk of readmission and mortality.3 Previously, the DAPA-HF (Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction) trial demonstrated that dapagliflozin significantly reduces the risk of worsening heart failure and cardiovascular deat

Many randomised-controlled clinical trials (RCTs), such as DAPA-HF, DELIVER, EMPEROR-Preserved, EMPEROR-Reduced and CREDENCE trials have been conducted, using the different SGLT2 inhibitors, and have reported increased positive outcomes in the HF population.1–6 The mechanism(s) behind the cardiovascular protective effects by SGLT2 inhibitors remains unclear. Pleiotropic effects have been suggested; other plausible mechanisms include improved glycaemic control, reduced albuminuria, reduced blood pressure and amelioration of fluid overload.7 However, the increased use of this class of medications should be undertaken with awareness of the pot

Introduction Dapagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, was first used as a type 2 diabetes drug. However, in the Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure (DAPA-HF) trial, dapagliflozin effectively reduced both hospitalisations due to heart failure (HF) and death in patients with HF with reduced ejection fraction (HFrEF).1 Therefore, the European Society of Cardiology (ESC) and Japanese Circulation Society (JCS) guidelines recommended the administration of SGLT2 inhibitors to patients with HFrEF.2,3 Moreover, dapagliflozin suppressed both renal failure exacerbation and all-cause death in patie

Introduction The prevalence of heart failure (HF) in the UK is estimated to be 920,000, with 200,000 new diagnoses every year.1 HF is the most common cause of admission for people over 65 years old and accounts for 2% of the National Health Service (NHS) total budget, which is approximately £2 billion. Seventy per cent of these costs are attributed to HF hospitalisation, amounting to £3,796 per episode of HF hospital admission, based on an average length of stay of 13 days.2 Additionally, untreated heart failure with reduced ejection fraction (HFrEF) has a mortality rate of approximately 40%,3,4 therefore, evidence-based pharmacological tre

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The EU approval is based on positive results from the landmark DAPA-HF phase III trial, published in The New England Journal of Medicine (DOI: 10.1056/NEJMoa1911303) and follows the recommendation for approval by the Committee for Medicinal Products for Human Use of the European Medicines Agency. Dapagliflozin is the first SGLT2 inhibitor to have shown a statistically significant reduction in the risk of the composite of cardiovascular death or worsening of heart failure events, including hospitalisation for HF.

Landmark trials in heart failure – 30 years from CONSENSUS With 2017 marking the 30th year since the publication of CONSENSUS,1 which first reported a reduction in mortality with enalapril versus placebo in patients with advanced heart failure (HF), the BCS held a dedicated session to review the seminal clinical trials and advances in chronic heart failure management in this period. Dr Rosita Zakeri (Royal Brompton Hospital, London) reviewed this session for us and spoke to the BJC afterwards. Rosita Zakeri The era of vasodilator therapy for heart failure began in the 1990s. Professor Karl Swedberg (University of Gothenberg, Sweden) began

Introduction Type 2 diabetes mellitus is a major risk factor for developing both microvascular (retinopathy, nephropathy and neuropathy) and macrovascular complications (coronary heart disease, cerebrovascular disease and peripheral vascular disease).1 The link between maintaining good glycaemic control and prevention of these complications is well established.2-4 Guidelines recommend a target glycosylated haemoglobin (HbA1c) of 7% or less, but a large number of patients fail to meet this target and, as of yet, no ideal pharmacological blood glucose-lowering agent exists. Existing pharmacological therapies, which have been previously describ