https://doi.org/10.55788/ba2d7a79
Dapagliflozin has been demonstrated to decrease clinical events in patients with stable HFrEF and recent data suggests that early clinical benefits may also be expected with this therapy [1]. To assess whether dapagliflozin indeed offers such early benefits for patients, Prof. Julio NĂșñez Villota (University of Valencia, Spain) and co-investigators designed the multicentre, randomised DAPA-VO2 trial (NCT04197635) [2]. In this study, 90 patients with stable HFrEF were randomised 1:1 to placebo or dapagliflozin in addition to guideline-directed medical therapy. The primary endpoint was the change in peakVO2 after 1 and 3 months. Prof. NĂșñez Villota emphasised that 2 out of 3 patients were on triple pharmacological therapy.
Dapagliflozin treatment significantly improved peakVO2 in HFrEF patients compared with placebo treatment after 1 month (Îmean change 1.09 mL/kg/min; P=0.021) and after 3 months (1.06; P=0.032). However, secondary endpoint measurements did not demonstrate clinical benefits of dapagliflozin over placebo after 1 month: 6-minute walk test (6MWT) (375.1 m vs 357.4 m; P=0.471), Minnesota Living with Heart Failure Questionnaire (MLHFQ) (24.0 vs 18.9; P=0.220), left ventricular ejection fraction (LVEF) (35.1 vs 35.6; P=0.882). Similarly, after 3 months, dapagliflozin treatment did not result in clinical benefits as per secondary outcome measures over the patients in the placebo arm; however, the study was not powered to detect differences at the magnitude seen in the pivotal phase 3 trial.
This is a small study, so firm conclusions cannot be drawn. âNonetheless, among patients with stable HFrEF dapagliflozin resulted in a significant improvement in the primary endpoint of this study, change in peakVO2, at 1 and 3 months,â concluded Prof. NĂșñez Villota.
- Berg DD, et al. JAMA Cardiol. 2021;6(5):499â507.
- Palau P, et al. Short-term Effects of Dapagliflozin on Peak VO2 in Heart failure and Reduced Ejection Fraction (DAPA-VO2): a Randomized Clinical Trial. LBT Pharmacological treatment II, Heart Failure 2022, 21â24 May, Madrid, Spain.
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Table of Contents: HFA 2022
Featured articles
Phase 3 and 4 Trials
GALACTIC-HF: Omecamtiv mecarbil as option for HFrEF patients with low SBP
HELIOS-A: Vutrisiran meets exploratory endpoints
Patiromer helps HFrEF patients to optimise RAAS inhibitors without hyperkalaemia
FIDELITY: Cardiorenal benefits of finerenone, regardless of LVH status
DAPA-VO2: Rapid effect of dapagliflozin on peak VO2 in stable HFrEF
Phase 1/2 Trials
Significant improvement in BP from istaroxime, a novel non-adrenergic agent
SERENADE: Macitentan fails in HFpEF plus PAH
Combination of filgrastim and dutogliptin appears safe in STEMI
Therapeutic Devices
Cardiac contractility modulation therapy promising for patients with HFpEF
REBALANCE-HF: Encouraging observations for splanchnic nerve ablation in HFpEF
Updates on SGLT2 Inhibitors
DAPA-HF: Dapagliflozin is safe and efficacious in frail patients
EMPEROR-Preserved: Empagliflozin stable across age groups
EMPULSE: Empagliflozin delivers rapid and clinically meaningful decongestion
Dapagliflozin performs consistently across LVEF in HF
Miscellaneous Topics
Cardiac wasting relevant for clinical outcomes in cancer
Urocortin-2 a potential treatment target for HFpEF
Should ATTR-CM be added to the differential diagnosis of patients with HF?
Delayed initiation of novel GDMTs associated with adverse outcomes in HF patients
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