Dapagliflozin is an effective treatment for patients with heart failure with reduced ejection fraction (HFrEF) across all age groups, according to the findings of a study presented at the American Heart Association 2019 Scientific Sessions in Philadelphia.
“Patients with HFrEF are often elderly and more likely to have comorbidities such as renal disease, which may limit the use of pharmacological therapies,” the research authors wrote in their abstract. “Therefore, we assessed the efficacy and safety of dapagliflozin according to age in DAPA-HF.”
The researchers enrolled 4,774 (mean age, 66, 23% female) patients from 410 centers across 20 countries between February 15, 2017 and August 17, 2018. The population of interest were considered eligible for enrollment if they were a New York Heart Association (NYHA) class II-IV, with a left ventricular ejection fraction (LVEF) of 40% or less; N-terminal (NT)-pro hormone BNP (NT-prBNP) of 600 pg/mL or greater; and on standard drug or device therapy for HF. Subjects were administered either 10 mg once daily of dapagliflozin or a matching placebo. The researchers assessed several outcomes, including all-cause and cardiovascular (CV) death and recurrent hospitalizations.
According to the study results, dapagliflozin attenuated the risk of worsening HF events and CV death and improved symptoms in patients with HFrEF when used in conjunction with standard therapy. The researchers noted that benefits were consistent across all age groups evaluated in the study. The relative and absolute risk reductions in death and hospitalization were substantial and clinically relevant. The absolute benefits in older patients were large because they were at higher risk than younger patients. Dapagliflozin was found to be well-tolerated, and the rate of treatment discontinuation was low across all age groups.
“Dapagliflozin offers a new approach to the treatment of HFrEF, irrespective of age,” Dr. Felipe Martinez, of Cordoba National University, noted in a presentation of the study results.