Dapagliflozin added to optimal medical therapy results in meaningful improvements in symptoms and health-related quality of life in heart failure patients with reduced ejection fraction (HFrEF), results of the DEFINE-HF trial show. However, the sodium glucose co-transporter-2 (SGLT2) inhibitor did not reduce levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) compared with placebo.
The DEFINE-HF trial, presented here today at the Heart Failure Society of America annual meeting and simultaneously published in Circulation, follows closely on the heels of DAPA-HF, which was presented 2 weeks ago at the European Society of Cardiology Congress 2019. In that trial, dapagliflozin resulted in a 26% reduction in worsening heart failure or death from cardiovascular causes, a 30% reduction in worsening heart failure events, and an 18% reduction in death from both cardiovascular and all-cause deaths in patients with HFrEF. Both trials suggest that dapagliflozin benefits HFrEF patients with and without diabetes.
“Collectively, we believe these results support the use of dapagliflozin as a new treatment option in patients with HFrEF regardless of their diabetes status, and we believe this will result in important implications for guidelines and clinical practice,” said Mikhail Kosiborod, MD (Saint Luke’s Mid America Heart Institute, Kansas City, MO), presenting the DEFINE-HF results here.
“The findings from DEFINE-HF are wholly in line with the larger HF outcomes trial of dapagliflozin, DAPA-HF,” co-author Darren McGuire, MD (UT Southwestern Medical Center, Dallas, TX), added in an email to TCTMD. “It will be very interesting to see the NT-proBNP results from DAPA-HF to see if there were differences over a longer period of time and if any associations between achieved NT-proBNP levels and hard clinical outcomes were observed.”