JDC Gems

7. Drug Update

DAPA-HF trial results announced

     Treatment with dapagliflozin was found to reduce the risk for worsening HF and CV death when added to standard therapy, according to results of DAPA-HF trial.

     During a median follow-up of 18.2 months, the primary outcome of CV death or worsening HF was reduced by 26% in the group assigned dapagliflozin compared with those assigned placebo (16.3% vs. 21.2%; HR = 0.74; 95% CI, 0.65-0.85; number needed to treat = 21). Worsening HF was defined as unplanned HF hospitalization or an urgent HF visit requiring IV therapy. Dapagliflozin was also associated with significant improvement when the researchers analyzed components of the primary composite endpoint separately, including a 30% reduction in worsening HF (HR = 0.7; 95% CI, 0.59-0.83; P = .00003) and an 18% reduction in CV mortality (HR = 0.82; 95% CI, 0.69-0.98; P = .029). All-cause death, which occurred in 11.6% of the dapagliflozin group vs. 13.9% of the placebo group, was reduced by 17% with dapagliflozin treatment (HR = 0.83; 95% CI, 0.71-0.97). DAPA-HF enrolled 4,744 adults in 20 countries who had HFrEF (left ventricular EF 40%). At baseline, 45% had type 2 diabetes and 55% did not. Those enrolled also had moderately elevated N-terminal pro-B-type natriuretic peptide and an estimated glomerular filtration rate of 30 mL/min/1.732 or higher. All patients underwent random assignment to receive once-daily dapagliflozin 10 mg or matching placebo, in addition to standard care.

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