AHA: Four in Five Heart Failure Patients Fit Criteria for Farxiga

Four in five patients with a common type of heart failure would benefit from treatment with Farxiga, according to a study presented today during the American Heart Association Scientific Sessions.

Farxiga (dapagliflozin) is one of the class of drugs known as SGLT2 inhibitors, which first reached the market in 2013 to treat type 2 diabetes but were found to be effective in reducing the likelihood of hospitalization for heart failure. Based on this, drug makers studied them to treat heart failure even if patients didn’t have diabetes.

Today’s findings, published in JAMA Cardiology, are the first of a six-part research effort involving a registry supported by seven drug companies with diabetes, cardiovascular and heart failure therapies either on the market or in the pipeline.

The DAPA-HF trial, presented September 1, 2019, showed that Farxiga cut the risk of worsening heart failure or cardiovascular death 26% regardless of diabetes status. For the results reported today, investigators applied the Farxiga label that was updated with a heart failure indication in May 2020 against a registry of 150,00 patients who were hospitalized for heart failure over a period of nearly five years.

Investigators noted that while today's results apply to Farxiga, recent results reported for Jardiance (empagliflozin) show that SGLT2 inhibitor also produced benefits in for patients with heart failure regardless of diabetes status.

The lead study author said that not all patients who might benefit from SGLT2 inhibitors are receiving them. Experts have reported that some cardiologists are reluctant to prescribe the drugs in their patients because they are still perceived to be diabetes drugs, even though they have an updated label.

“Despite accelerating scientific discoveries, few patients with heart failure are being treated with the best available treatment options in 2020,” Muthiah Vaduganathan, MD, MPH, and a cardiologist at Brigham and Women’s Hospital and Harvard Medical School, said in a statement. “While SGLT2 inhibitors were first developed for treatment of diabetes, these therapies have now been recognized to reduce mortality, prevent worsening heart failure events, and improve health-related quality of life in patients with HFrEF, including among those without diabetes.”

In addition to showing the missed opportunity to treat more heart failure patients generally, the results show that better awareness and greater willingness of cardiologists to prescribe SGLT2 inhibitors might help reach women and Black patients, who were less well represented in the DAPA-HF trial.

“Although there were more older adults, women, and Black patients in the [AHA] registry than in the DAPA-HF trial, most clinical characteristics were qualitatively similar between the 2 groups,” the study authors wrote, adding that compared with the DAPA-HF trial population, “there was lower use of evidence-based HF therapies,” among patients in the AHA registry.