Results from the Study to Evaluate the Effect of Dapagliflozin on the Incidence of Worsening Heart Failure or Cardiovascular Death in Patients With Chronic Heart Failure (DAPA-HF) showed that dapagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, reduced the incidence of type 2 diabetes by 32% in patients with heart failure but without diabetes at baseline.
The results were presented during the Scientific Sessions as an ADA Presidents’ Select Abstract titled Effect of Dapagliflozin on the Incidence of Diabetes: A Prespecified Exploratory Analysis from DAPA-HF. The presentation can be viewed by registered meeting attendees at ADA2020.org through September 10, 2020. If you haven’t registered for the Virtual 80th Scientific Sessions, register today to access all of the valuable meeting content.
“In this very high-risk population, the safety profile of dapagliflozin was excellent, the treatment well-tolerated with low discontinuation rates,” said Silvio E. Inzucchi, MD, Professor of Medicine (Endocrinology) at Yale School of Medicine and Medical Director of the Yale Diabetes Center. “While the major role of dapagliflozin is to reduce cardiovascular mortality and worsening of heart failure, decreasing incident diabetes could be considered an additional benefit.”
Funded by AstraZeneca, DAPA-HF was designed to evaluate the effect of dapagliflozin on the incidence of worsening heart failure or cardiovascular death in patients with chronic heart failure with reduced ejection fraction (HFrEF). The study enrolled 4,744 patients in 20 countries who were randomized to placebo or 10 mg of dapagliflozin daily. More than 2,600 (55%) of the study participants were nondiabetic at baseline. Of the nondiabetic participants, 157 (6%) developed type 2 diabetes during the trial. Based on the ADA definition of an A1C of 5.7% to 6.4%, more than 95% of those with new-onset diabetes had prediabetes at baseline.
Initial results from DAPA-HF, published in 2019, indicated that the risk of worsening heart failure or death from cardiovascular causes was lower among patients with HFrEF who received dapagliflozin than among those who received placebo, regardless of the presence or absence of diabetes. The U.S. Food and Drug Administration recently approved dapagliflozin oral tablets for adults with HFrEF to reduce the risk of cardiovascular death and hospitalization for heart failure.
Investigators also discussed DAPA-HF trial results during the symposium DAPA-HF Update—Have We Lost SGLT2 Inhibitors to Cardiologists?! This presentation also can be viewed by registered meeting attendees at ADA2020.org through September 10, 2020.
“Dapaglifozin offers a new approach not to just reduce cardiovascular death and hospitalizations for heart failure, but also to improve symptoms, functional limitations, and quality of life in patients with HFrEF,” said Mikhail N. Kosiborod, MD, Director of Cardiometabolic Research and Co-Director of the Saint Luke’s Michael and Marlys Haverty Cardio Metabolic Center of Excellence at Saint Luke’s Mid America Heart Institute.
Jeffrey M. Testani, MD, Associate Professor Term and Director of Heart Failure Research, Cardiovascular Medicine, at Yale School of Medicine, added: “Despite the fact that SGLT2 inhibitors will often be the fourth or fifth drug added to heart failure patients’ medication regimen, I am optimistic that clinical adoption is going to be extensive.”
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