Second SGLT2 inhibitor approved for heart failure
https://www1.racgp.org.au/newsgp/clinical/second-sglt2-inhibitor-approved-for-heart-failure
From 1 April, empagliflozin has been available as adjunct therapy for adults with heart failure with reduced ejection fraction (HFrEF). The sodium-glucose co-transporter-2 (SGLT2) inhibitor, sold as Jardiance, joins dapagliflozin (sold as Forxiga) as the second medicine of this class to be approved for use in heart failure (HF).
Patients must be symptomatic with New York Heart Association (NYHA) class II-IV HF and have a documented left ventricular ejection fraction less than or equal to 40%. The treatment must be an add-on therapy to optimal HFrEF treatment.
The listing follows the results of the EMPEROR-Reduced clinical trial, a phase 3 study which found that patients with HFrEF who were treated with empagliflozin (10 mg once daily) in addition to standard therapy, had a lower risk of cardiovascular death and HF-related hospitalisation (19.4%) than those in the placebo group (24.7%). Similar outcomes were seen in studies looking at dapagliflozin, including the DAPA-HF clinical trial.
Eligible patients with HFrEF are recommended to take one 10 mg tablet of empagliflozin daily in addition to optimised standard therapy. Common adverse effects include urinary tract and genital infections. Caution is advised in patients with reduced renal function, acute serious illness or volume depletion, and those also taking loop diuretics.