Home > Cardiology > HFA 2022 > Phase 3 and 4 Trials > DAPA-VO2: Rapid effect of dapagliflozin on peak VO2 in stable HFrEF

DAPA-VO2: Rapid effect of dapagliflozin on peak VO2 in stable HFrEF

Presented by
Prof. Julio NĂșñez Villota , University of Valencia, Spain
Conference
HFA 2022
Trial
Phase 4, DAPA-VO2
Doi
https://doi.org/10.55788/ba2d7a79
Patients with stable heart failure with reduced ejection fraction (HFrEF) who were treated with dapagliflozin displayed a significant positive effect on peakVO2 already after 1 month of treatment, an effect that lasted for at least 3 months. This was the main primary result of the DAPA-VO2 trial.

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 (Δmean 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. “Nonetheless, 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,” concluded Prof. NĂșñez Villota.

  1. Berg DD, et al. JAMA Cardiol. 2021;6(5):499–507.
  2. 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, 21–24 May, Madrid, Spain.

 

Copyright ©2022 Medicom Medical Publishers



Posted on