Benefits of a new drug in people with heart failure

Heart failure is a chronic disease that worsens over time and that in countries like Spain affects 2% of the population. Worldwide, the number of affected is estimated at about 64 million people. In addition, it is the main cause of hospitalization for people over 65 years of age.

The results of a clinical trial with the participation of the Bellvitge Biomedical Research Institute (IDIBELL), located in Hospitalet de Llobregat and which is part of the CERCA institution of the Generalitat of Catalonia, confirm the benefits of a new drug in people with heart failure .

The main conclusion of the phase III international trial is the confirmation that the efficacy of dapagliflozin in reducing mortality and worsening in people with heart failure is global in nature, regardless of their ejection fraction ( the percentage of blood that the left ventricle of the heart pumps with each contraction and the main value to determine the severity of heart failure).

The results of the Phase III DELIVER trial have been published in The New England Journal of Medicine (NEJM). “The study represents a revolution in the treatment of patients with heart failure since for the first time it is shown that a drug such as dapagliflozin improves clinical outcomes and quality of life throughout the entire spectrum of ventricular function,” he says. Dr. Josep Comin, co-author of the study, head of the Cardiology Service at the Bellvitge University Hospital (HUB) and director of the IDIBELL BIO-Heart Research Group on Cardiovascular Diseases.

An auscultation using a stethoscope allows, among other things, to hear if the rhythm of the heartbeat is normal or, on the contrary, if it presents abnormalities that could denote the existence of heart problems. (Photo: Amanda Mills/CDC)

Dr. Comin has been responsible for the development of the study in Spain. In this sense, it should be noted that the HUB and the BIO-Heart Group have coordinated the more than 300 patients from all over the state who have participated in the study, out of a total of more than 6,200 worldwide.

The results of the trial show that the administration of dapagliflozin, in a single daily oral dose, is capable of reducing the compound effect of cardiovascular death and worsening of heart failure by 18%. In addition, the joint analysis of the study and another that has also focused on the drug itself, DAPA-HF, showed that the reduction in the risk of cardiovascular death was 14%.

What is dapagliflozin?

It is the first inhibitor and sodium glucose cotransporter 2 or SGLT2, for oral use, which until now was approved for the treatment of type 2 diabetes mellitus, as a complement to diet and exercise, since it reduces blood sugar by making the kidneys excrete more glucose in the urine. Marketed by Astra Zeneca, dapagliflozin is also approved for the treatment of heart failure with reduced ejection fraction (LVEF) and chronic kidney disease. As Dr. Comin points out, “now the range of heart failure patients who can count on effective treatment is extended to include those with intermediate or slightly reduced LVEF.”

He adds that “The results of the study will mean a change in the current recommendations of international clinical practice guidelines and are a paradigmatic example of knowledge transfer to clinical practice in which the HUB and IDIBELL have contributed significantly.” (Source: IDIBELL)