Pharmacist Department of Pharmacy, LinKou Chang Gung Memorial Hospital, Taoyuan, Taiwan, Taiwan (Republic of China)
Background: Dapagliflozin and empagliflozin, the sodium-glucose cotransporter 2 (SGLT2) inhibitors, have been proven to reduce cardiovascular death in heart failure (HF) patients with reduced ejection fraction. However, limited data are available on practicing the generalizability of dapagliflozin and empagliflozin treatment in real-world patients.
Objectives: To evaluate the generalizability of the real-world dapagliflozin or empagliflozin new users in Taiwan based on the major inclusion criteria according to the DAPA-HF and EMPEROR-Reduced trials.
Methods: We conducted a retrospective study by analyzing the Chang Gung Research Database (CGRD), the largest multi-institutional electronic medical records collection in Taiwan. We included the patients newly receiving dapagliflozin or empagliflozin 10mg for HF treatment between May 2022 and November 2022. Subsequently, we collected dapagliflozin or empagliflozin users’ characteristics to analyze the generalizability of the DAPA-HF and EMPEROR-Reduced trials which have the major inclusion criteria: 1) left ventricular ejection fraction (LVEF) ≤ 40%, 2) hospitalization for HF before 12 months, 3) increased N-terminal pro-brain natriuretic peptide (NT-proBNP) levels ≥ 600 pg/mL.
Results: A total of 505 heart failure patients were evaluated, 441 (87.3%) dapagliflozin and 64 (12.7%) empagliflozin new users with 242 (54.9%) and 47 (73.4%) patients were diagnosed with diabetes, respectively. Among dapagliflozin users, 54 (22.3%), 42 (17.4%), and 22 (9.1%) met LVEF ≤ 40%, hospitalization for HF before 12 months, and increased NT-proBNP levels ≥ 600 pg/mL. On the other hand, among empagliflozin users, 3 (6.4%), 3 (6.4%), and 1 (2.1%) met LVEF ≤ 40%, hospitalization for HF before 12 months, and increased NT-proBNP levels ≥ 600 pg/mL.
Conclusions: Our research shows dapagliflozin new users were more similar to heart failure clinical trials than empagliflozin users. Further research is needed to analyze the effectiveness of two agents among real-world heart failure patients.
.jpg "Po-Cheng Yen, M.S. photo")
