Diabetes a drug may also treat heart
failure, study suggests !!!
Dapagliflozin, which is used to treat diabetes, can also
treat heart failure in patients with and without diabetes, according to
researchers in Scotland.
They found that dapagliflozin, a drug already used to
successfully treat type 2 diabetes and prevent development of heart failure,
can also be used to treat pre-existing heart failure.
They said the clinical implications of the findings from the
DAPA-HF study were “huge” for heart failure treatment.
Dapagliflozin is one of the relatively new class of diabetes
drugs called Sodium-glucose cotransporter 2 (SGLT-2) inhibitors.
Previous studies have shown that SGLT-2 inhibitors not only
help control blood glucose levels, but can also improve a number of
cardiovascular outcomes, including promoting weight loss, reducing blood
pressure and reducing the risk of cardiovascular mortality.
Dapagliflozin has already been proved to reduce the risk of
developing heart failure in patients with type 2 diabetes.
In the new study, researchers analyzed whether the drug could
also be used to treat type 2 diabetes patients with established heart failure
and also heart failure in patients without type 2 diabetes.
The trial enrolled 4,744 patients with heart failure and
reduced ejection fraction in 20 countries, of whom 45% had type 2 diabetes, and
55% did not.
Patients were randomly allocated to either dapagliflozin 10mg
once daily or matching placebo. The primary endpoint was a combination of a
first episode of worsening heart failure or death from cardiovascular causes.
The treatments in the study were given on top of standard
care, with 94% receiving an angiotensin-converting enzyme (ACE) inhibitor or
angiotensin receptor blocker or angiotensin receptor-neprilysin inhibitor, 96%
a beta-blocker and 71% a mineralocorticoid receptor antagonist.
The researchers found that, over a median follow-up of 18.2
months, the primary outcome occurred in 16.3% in the dapagliflozin group and in
21.2% in the placebo group, translating to a 26% reduced risk in the
dapagliflozin. The results were similar in the groups with type 2 diabetes and
without the condition.
Components of the primary outcome were also analysed
separately, showing a 30% reduced risk of worsening heart failure in the
dapagliflozin group and an 18% lower risk of death from cardiovascular causes.
All-cause mortality was reduced by 17%.
Meanwhile, 7.5% in the dapagliflozin group had an adverse
event-related to volume depletion, compared to 6.8% in the placebo group, with
no significant difference between groups.
Adverse events related to kidney dysfunction occurred in 6.5%
of patients in the dapagliflozin group versus 7.2% in the placebo group, with
no significant difference between groups.
Major hypoglycaemia and lower limb amputation and fracture
were infrequent and occurred at similar rates in the two treatment groups.
Lead study author Professor John McMurray, from the Institute
of Cardiovascular and Medical Sciences at the University of Glasgow, said: "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,” he said.
“Adverse events rarely required the discontinuation of
treatment,” he said. There was no notable excess of any serious adverse event
in the dapagliflozin group.
“The trial shows that dapagliflozin reduces death and
hospitalisation, and improves health-related quality of life, in patients with
heart failure and reduced ejection fraction, with and without diabetes.
He
added: “The clinical implications are potentially huge – few drugs achieve
these results in heart failure and dapagliflozin does even when added to
excellent standard therapy.”
To expand knowledge about diabetes and heart diseases, visit our website: https://diabetes-heart-disease.healthconferences.org/
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