This drug could help treat 80% of people with heart failure

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In a new study, researchers found that four out of five patients with heart failure with reduced ejection fraction (HFrEF) could be considered for treatment with dapagliflozin, an sodium-glucose co-transporter-2 (SGLT2) inhibitor.

The research was conducted by a team at Brigham and Women’s Hospital and Harvard Medical School.

While SGLT2 inhibitors were first developed for treatment of diabetes, these therapies have now been recognized to reduce mortality, prevent worsening heart failure events, and improve health-related quality of life in patients with HFrEF, including among those without diabetes.

Clinical trials evaluating novel therapies are often conducted in highly selected groups of patients, raising questions regarding the applicability of the trial results to “real world” patients in clinical practice.

The objective of the study was to determine the proportion of patients with heart failure who would meet eligibility for treatment with dapagliflozin.

While SGLT2 inhibitors were initially developed for the management of type 2 diabetes, dapagliflozin is the first SGLT-2 inhibitor to be approved for use for heart failure, irrespective of diabetes status.

The team analyzed data from over 150,000 patients hospitalized for HFrEF at over 400 hospital centers.

They found that 80% of patients in the registry met the FDA criteria for HF treatment with dapagliflozin;

A similarly high proportion of patients with type 2 diabetes and without type 2 diabetes met eligibility criteria;

Advanced kidney disease was the most common reason for not being a dapagliflozin candidate;

Treatment candidates identified in the GWTG-HF registry shared many clinical characteristics with participants enrolled in DAPA-HF,3 the pivotal trial that established the efficacy and safety of dapagliflozin in HFrEF.

The findings support the view that the SGLT2 inhibitors are now established as a new pillar of care for patients with heart failure.

The team says doctors must now rapidly translate this knowledge to practice to improve patient outcomes.

One author of the study is Muthiah Vaduganathan, M.D., M.P.H.

The study was presented at the American Heart Association’s Scientific Sessions 2020 and is published in JAMA Cardiology.

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