A medication originally developed to treat diabetes is also showing promise in treating a mild form of heart failure named HFpEF.
An article in today’s journal, Nature Medicine, chronicles the results of a nationwide 12-week study, conducted in part at the EVMS Strelitz Diabetes Center. The study is sponsored by Astra Zeneca, but the idea of the study is investigator initiated and is led and coordinated by Saint Luke’s Mid America Heart Institute, in Kansas City, MO. The study which was conducted in patients with a milder form of heart failure (HFpEF), showed strong evidence that the medication dapagliflozin improves symptoms, functional status and quality of life, according to Elias S. Siraj, MD, Professor of Medicine, Chief of Endocrine and Metabolic Disorders and Director of the EVMS Strelitz Diabetes Center and the Principal Investigator of the study at the EVMS site.
Dapagliflozin belongs to a class of drugs known as sodium-glucose cotransporter 2 inhibitors (SGLT-2). Those medications were developed to treat diabetes by shedding excessive amounts of glucose through the urine, but it appears they have also beneficial effect on the heart through their action on the kidney, the heart and blood vessels, Dr. Siraj says.
Newer studies have demonstrated that, in patients who previously had cardiovascular disease and heart failure, SGLT-2 inhibitors help lower the risk of getting new cardiovascular events, death and reduce the likelihood of hospital admission, but no studies in heart failure patients have previously shown benefits in symptoms , functional status & quality of life. “Our study was the first to show such benefit in any trial with a drug for any type of heart failure”, says Dr. Siraj.
The study encompassed 324 patients with heart failure (about half of them have diabetes as well) at 26 sites, including the Strelitz Diabetes Center. In the blinded, placebo-controlled study, half of the patients were randomly selected to receive the study medication and the other half received a sugar pill. The benefit was seen in patients with and without diabetes.
“It can be challenging to treat someone with a chronic condition,” says Dr. Siraj. “You want them to live longer and have less complications, but at the same time you want them to have fewer symptoms and better quality of life on a day to day basis. “That is why this is of huge importance for people with heart failure”, highlights Dr. Siraj.
Cardiologists are particularly excited by the mounting evidence about the positive effects of SGLT-2 inhibitors in patients with heart disease, says Dr. Siraj. “In patients with the milder type of heart failure (HFpEF), it has been challenging to find an effective treatment to relieve their symptoms, and therefore the finding of our study has a potential to be game changer” explains Dr. Siraj .
The full paper, “Effects of Dapagliflozin on Symptoms, Physical Limitations and Exercise Function in Heart Failure with Preserved Ejection Fraction: A Randomized Controlled Trial” is available online.