Does heart failure respond to Farxiga (dapagliflozin)?

From the Guidelines

Farxiga (dapagliflozin) is indeed prescribed for heart failure, particularly heart failure with reduced ejection fraction (HFrEF), as it has been shown to reduce the risk of worsening heart failure and cardiovascular death by approximately 25% 1.

Key Points

• The benefits of Farxiga in heart failure patients are seen irrespective of baseline diabetes status 1.
• The typical dose for heart failure is 10 mg once daily.
• Farxiga works by helping the kidneys remove glucose from the bloodstream, but it also provides heart failure benefits by reducing cardiac workload, improving energy metabolism in the heart, and decreasing inflammation.
• Patients with heart failure taking Farxiga may experience reduced hospitalizations and mortality rates, with a significant 18% reduction in cardiovascular death 1.
• Common side effects include genital yeast infections, urinary tract infections, and volume depletion.
• It's essential for patients to stay well-hydrated while taking this medication and to temporarily stop it during severe illness, surgery, or if unable to eat or drink normally.
• The most recent and highest quality study, 1, supports the use of SGLT2 inhibitors, such as Farxiga, in people with type 2 diabetes and established HFpEF or HFrEF to reduce the risk of worsening heart failure and cardiovascular death.

Important Considerations

• Patients should discuss with their doctor whether Farxiga is appropriate for their specific type of heart failure and medical history.
• The benefits of Farxiga in heart failure patients have been consistently demonstrated across multiple trials, including the DAPA-HF and EMPEROR-Reduced trials 1.
• The medication has been shown to reduce the risk of hospitalization for heart failure by approximately 30% 1.

From the FDA Drug Label

In DAPA-HF, dapagliflozin reduced the total number of hospitalizations for heart failure (first and recurrent) events and CV death, with 567 and 742 total events in the dapagliflozin-treated vs placebo group [Rate Ratio 0.75 (95% CI 0.65,0.88); p=0. 0002]. Dapagliflozin also reduced the incidence of the composite endpoint of CV death or hospitalization for heart failure [HR 0.71 (95% CI 0.55,0.92), p=0.0089] and all-cause mortality [HR 0.69 (95% CI 0.53,0.88), p=0. 0035].

Yes, dapagliflozin (Farxiga) is used to treat heart failure. The main benefits of using dapagliflozin for heart failure include:

• Reduced hospitalization for heart failure
• Reduced cardiovascular death
• Reduced all-cause mortality 2 2

From the Research

Heart Failure Treatment with Farxiga

• Farxiga (dapagliflozin) is a sodium-glucose cotransporter 2 (SGLT2) inhibitor that has been approved for the treatment of adults with symptomatic heart failure with reduced ejection fraction (HFrEF) 3.
• The cardiovascular benefits of dapagliflozin were first observed in the DECLARE-TIMI 58 trial, which showed that dapagliflozin significantly reduced the risk of cardiovascular death or hospitalization for heart failure in patients with type 2 diabetes mellitus (T2DM) who had or were at risk for atherosclerotic cardiovascular disease 3.
• The DAPA-HF trial demonstrated that dapagliflozin in addition to standard of care was associated with a significantly lower risk of worsening heart failure or cardiovascular death than placebo in patients with HFrEF, regardless of the presence or absence of T2DM 3, 4.
• The benefits of dapagliflozin have also been shown to be effective in patients with heart failure and a mildly reduced or preserved ejection fraction, as demonstrated in the DELIVER trial 5.
• The use of SGLT2 inhibitors, including dapagliflozin, has been shown to reduce the risk of hospitalization for heart failure and cardiovascular death in patients with heart failure with reduced ejection fraction, regardless of the presence or absence of diabetes 6.

Dosage and Tolerability

• The dosage of dapagliflozin used in clinical trials was 10 mg once daily, which was generally well tolerated with an overall safety profile consistent with its known safety profile in other indications 3, 4.
• The dosing of pharmacological therapy in heart failure, including SGLT2 inhibitors, has been reevaluated, with a focus on starting treatment as quickly as possible and titrating to a target dose as a secondary consideration 7.