From the Guidelines
Jardiance (empagliflozin) is a recommended medication for the treatment of heart failure, particularly in patients with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF), due to its ability to reduce the risk of cardiovascular death and hospitalization for heart failure by approximately 21%. The recommended starting dose is 10 mg once daily, which can be taken with or without food. Jardiance works by inhibiting sodium-glucose cotransporter-2 (SGLT2) in the kidneys, which not only promotes glucose excretion but also provides cardiovascular benefits through multiple mechanisms including improved cardiac energetics, reduced cardiac preload and afterload, and anti-inflammatory effects.
Key Benefits of Jardiance in Heart Failure
- Reduces the risk of cardiovascular death and hospitalization for heart failure by approximately 21% 1
- Provides benefits in patients with HFrEF and HFpEF, regardless of the presence of diabetes 1
- Can be used in patients with reduced kidney function down to an eGFR of 20 ml/min/1.73m²
- Offers the dual benefit of glycemic control and heart failure management in patients with diabetes
Important Considerations
- Patients should be monitored for potential side effects including genital mycotic infections, urinary tract infections, and volume depletion, especially when initiating therapy 1
- Kidney function should be assessed before starting treatment 1
- Jardiance is recommended as part of a comprehensive treatment plan for heart failure, which may include other medications such as ACE inhibitors, beta blockers, and diuretics 1
Clinical Trial Evidence
- The EMPEROR-Reduced trial demonstrated a 21% reduction in the risk of cardiovascular death or hospitalization for worsening heart failure with empagliflozin compared to placebo 1
- The DAPA-HF trial showed a 26% reduction in the risk of worsening heart failure or cardiovascular death with dapagliflozin compared to placebo 1
- The DELIVER trial demonstrated an 18% reduction in the risk of worsening heart failure or cardiovascular death with dapagliflozin compared to placebo 1
From the Research
Role of Jardiance in Heart Failure
- Jardiance (empagliflozin) has been shown to be effective in reducing the risk of hospitalization for heart failure in patients with heart failure with reduced ejection fraction (HFrEF) 2, 3.
- The EMPEROR-Reduced study found that empagliflozin reduced the risk of cardiovascular death or hospitalization for heart failure by 25% compared to placebo in patients with HFrEF 2, 3.
- Empagliflozin has also been shown to be effective in patients with heart failure with preserved ejection fraction (HFpEF), reducing the risk of cardiovascular death or hospitalization for heart failure by 21% compared to placebo 4.
- The benefits of empagliflozin in heart failure are thought to be due to its diuretic effect, which helps to reduce fluid retention and alleviate symptoms of heart failure 5.
Key Findings
- Empagliflozin has been shown to reduce the risk of hospitalization for heart failure in patients with HFrEF and HFpEF, regardless of the presence or absence of diabetes 2, 3, 4.
- The drug has been found to be generally well-tolerated, with a similar adverse event profile to placebo, except for an increased risk of genital tract infections 2, 3, 4.
- Empagliflozin has also been shown to slow the decline in estimated glomerular filtration rate (eGFR) and reduce the risk of serious renal outcomes in patients with heart failure 3.
Clinical Implications
- Empagliflozin is a valuable treatment option for patients with symptomatic heart failure, regardless of ejection fraction 6.
- The drug can be used in addition to standard therapy for heart failure, and has been shown to be effective in reducing the risk of cardiovascular death or hospitalization for heart failure 2, 3, 4.
- Clinicians should consider empagliflozin as a treatment option for patients with heart failure, particularly those with a history of hospitalization for heart failure or those with reduced ejection fraction 2, 3.