The diabetes drug dapagliflozin (Farxiga, AstraZeneca) provides substantial benefits among patients with chronic heart failure with reduced ejection fraction (HFrEF) -even in those without diabetes, according to the DAPA HF trial.
The sodium-glucose cotransporter 2 (SGLT2) inhibitor reduced the relative risk for the primary outcome – a composite of time to first cardiovascular (CV) death or HF hospitalization or urgent HF visit requiring intravenous therapy -by 26% when added to standard therapy, compared with standard care alone (hazard ratio [HR], 0.74; 95% CI, 0.65 – 0.85; P = .00001). The number needed to treat was 21. Dapagliflozin reduced the risk for all-cause death by 17% (HR, 0.83; 95% CI, 0.71 – 0.97) and patient-reported HF symptoms, without an increase in adverse events.
DAPA HF is considered a landmark study showing the benefits of the use of SGLT2 inhibitors in heart failure patients, which has been documented in EMPA-REG OUTCOME and CANVAS, however, this study was only performed on diabetics.