Effect of Dapagliflozin in DAPA-HF According to Background Glucose-Lowering Therapy

• Published in: Diabetes care Vol. 43; no. 11; pp. 2878 - 2881
• Main Authors: Docherty, Kieran F, Jhund, Pardeep S, Bengtsson, Olof, DeMets, David L, Inzucchi, Silvio E, Køber, Lars, Kosiborod, Mikhail N, Langkilde, Anna Maria, Martinez, Felipe A, Sabatine, Marc S, Sjöstrand, Mikaela, Solomon, Scott D, McMurray, John J V
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.11.2020
• Subjects: Aged; Antidiabetics; Benzhydryl Compounds - administration & dosage; Benzhydryl Compounds - adverse effects; Blood Glucose - drug effects; Clinical outcomes; Clinical trials; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - mortality; Double-Blind Method; Drug therapy; Drug Therapy, Combination - adverse effects; Female; Glucose; Glucosides - administration & dosage; Glucosides - adverse effects; Heart diseases; Heart failure; Heart Failure - complications; Heart Failure - mortality; Hospitalization; Humans; Intravenous administration; Kaplan-Meier Estimate; Male; Metformin - administration & dosage; Metformin - adverse effects; Middle Aged; Novel Communications in Diabetes; Proportional Hazards Models; Prospective Studies; Sodium-Glucose Transporter 2 Inhibitors - administration & dosage; Sodium-Glucose Transporter 2 Inhibitors - adverse effects; Stroke Volume; Therapy; Treatment Outcome
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/dc20-1402

To determine whether the benefits of dapagliflozin in patients with heart failure and reduced ejection fraction (HFrEF) and type 2 diabetes in the Dapagliflozin And Prevention of Adverse-Outcomes in Heart Failure trial (DAPA-HF) varied by background glucose-lowering therapy (GLT). We examined the effect of study treatment by the use or not of GLT and by GLT classes and combinations. The primary outcome was a composite of worsening heart failure (hospitalization or urgent visit requiring intravenous therapy) or cardiovascular death. In the 2,139 type 2 diabetes patients, the effect of dapagliflozin on the primary outcome was consistent by GLT use or no use (hazard ratio 0.72 [95% CI 0.58-0.88] vs. 0.86 [0.60-1.23]; interaction = 0.39) and across GLT classes. In DAPA-HF, dapagliflozin improved outcomes irrespective of use or no use of GLT or by GLT type used in patients with type 2 diabetes and HFrEF.