There is now a new medicine for heart failure patients. Dapagliflozin is the first and only drug under the sodium glucose transport protein 2 inhibitor (SGLT2i) class approved to treat heart failure in adult patients with reduced ejection fraction (pumapalyang puso). It is the only SGLT2i proven to significantly prevent cardiovascular death and death due to other causes in these heart failure patients. Despite advances in the current treatments, heart failure is still a life threatening condition with nine of out 10 patients remaining to be symptomatic and half of the patients will die within five years of diagnosis.
This approval was based on the landmark trial Dapagliflozin and Prevention of Adverse-outcomes in Heart Failure Trial (DAPA HF). It is the first outcomes trial with an SGLT2 inhibitor investigating the treatment of Heart failure with reduced ejection fraction (HFrEF), with and without type-2 diabetes (T2D). The results showed a reduction of 26% in the occurence of cardiovascular death, hospitalization for heart failure (hHF) and Urgent Hospital Visit for heart failure (HF) along with a 30% reduction in hHF. Dapagliflozin’s significant 18% reduction in cardiovascular death and 17% reduction on death due to other causes which were only seen in the DAPA HF study.
Dapagliflozin has offered an additional treatment option for patients suffering from the symptoms of heart failure and are at risk of dying given the high mortality rate of the disease. Safety findings in patients with and without type 2 diabetes were consistent with the well established safety profile of Dapagliflozin in previous studies. It is consistent regardless of age, gender, severity of heart failure, diabetes status and kidney function. Dapagliflozin was well tolerated and adverse event rarely led to the discontinuation of treatment.
“AstraZeneca is committed to uplift the standard of care of Filipino patients by providing them with innovative and accessible treatment. The results from DAPA HF highlight the potential of a novel approach to greatly improve outcomes for patients with HFrEF by slowing disease progression and improving morbidity and mortality. Dapagliflozin has the potential to become a long-awaited addition in the standard of care for this patient population. This is a testament of the company’s commitment in pushing what science can do to address unmet needs in healthcare,” said Lotis Ramin, AstraZeneca Philippines Country President.
Dr. Orly Bugarin, President of the Philippine Heart Association: “The approval of Dapagliflozin for the treatment of heart failure bolds well in the Philippine situation. Despite advances in therapy with heart failure, mortality and morbidity remain high. This signifies that there is still an unmet need for an effective heart failure treatment which Dapagliflozin may address.”
This was confirmed by Dr. May Donato-Tan, President of Heart Failure Society of the Philippines, who stated that, “Dapagliflozin is a welcome strong addition in the field of heart failure because it allows heart failure patients to prevent hospitalizations and death from other cardiovascular causes. The approval of Dapagliflozin gives hope to heart failure Filipino patients.”
Heart failure a growing concern among Filipinos
Heart failure (pumapalyang puso) is a life-threatening disease in which the heart cannot pump enough blood around the body. It is a global problem, affecting approximately 64 million people worldwide where half of the patients will die within five years of diagnosis. It is the leading cause of hospitalization for those over the age of 65 and represents a significant clinical and economic burden. Further, studies have indicated that heart failure strikes Asians early, a decade younger than their western counterparts.
In the Philippines, heart disease continues to be the leading cause of death, with 74,134 reported cases in 2016. Also, the World Health Organization predicts that from 2.7 million in 2000, the number of diabetics in the country will reach 7.7 million by the year 2030. These two diseases are very closely linked to each other, with heart failure being one of the most common complications of diabetes.
In the Philippines, Dapagliflozin is approved for glycemic control and for the prevention of new or worsening hospitalization for heart failure or cardiovascular death and nephropathy in adult patients with Type 2 Diabetes. It is now approved for the treatment of heart failure with reduced ejection fraction in adult patients. Dapagliflozin is a prescription medicine. Patients should not self-medicate and should consult their physicians regarding their condition and treatment.