SGLT2 Inhibitor Dapagliflozin Lowers Risk for Worsening Heart Failure

By Joe Elia

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

Dapagliflozin lowered the risk for worsening heart failure or cardiovascular death among patients with reduced left-ventricular ejection fractions, regardless of their diabetes status. The drug inhibits sodium-glucose cotransporter 2 (SGLT2).

In an international phase 3 trial conducted with the drugmaker's participation, some 4700 patients with New York Heart Association class II or higher heart failure and ejection fractions of 40% or less received either daily dapagliflozin or placebo, in addition to their regular treatment. The primary outcome was a composite of worsening heart failure or cardiovascular death.

After a median 18-month follow-up, dapagliflozin bested placebo: the composite outcome occurred in 16% versus 21%, respectively. The authors estimate that 21 people would need to take dapagliflozin to prevent one primary event. The presence or absence of diabetes had no effect on the findings.

An editorialist in the New England Journal of Medicine calls the results "compelling." He suggests that further studies be conducted among more patients with severe heart failure, since most of the group studied had moderate disease.