Type 2 diabetics who took Farxiga (dapagliflozin) saw their odds of hospitalization for heart failure drop by 27 percent compared to those who took a placebo, according to a study funded by the drug’s maker, Astra-Zeneca.
“When it comes to helping our patients control and manage blood glucose, the ‘how’ appears to be as important [as] the ‘how much,” said study author Dr. Stephen Wiviott, a cardiovascular medicine specialist at Brigham and Women’s Hospital in Boston.
“When choosing a therapy, trial results like these can help us make an informed decision about what treatments are not only safe and effective for lowering blood glucose but can also reduce risk of heart and kidney complications,” Wiviott said in a hospital news release.
The findings were published Nov. 10 in the New England Journal of Medicine, to coincide with their presentation at the annual meeting of the American Heart Association in Chicago.
The new study included more than 17,000 type 2 diabetes patients aged 40 and older. Nearly 7,000 had heart disease and more than 10,000 had numerous risk factors for heart disease, Wiviott’s group said.
Patients were randomly assigned to take either a “dummy” placebo pill or 10 milligrams of Farxiga each day.
Taking the drug did not reduce the risk of heart attack, stroke and cardiovascular-related death, the research team found. However, patients who took the drug did see healthy declines in their blood sugar levels, plus an added bonus: a 27 percent decrease in their risk of hospitalization for heart failure.
Their risk of kidney failure and death from kidney failure also fell, the Boston team said.
Farxiga is a type of drug called a SGLT2 inhibitor. Two other recent studies of this class of drugs show that they “robustly and consistently improve heart and [kidney] outcomes in a broad population of patients with diabetes,” Wiviott noted.
One cardiologist who wasn’t involved in the study said the findings are welcome news for people with diabetes.
“Sadly, more than 70 percent of deaths in diabetic patients is from cardiovascular causes,” said Dr. Cindy Grines, who heads cardiology at North Shore University Hospital, in Manhasset, N.Y.
She noted that, in the past, there was concern that some diabetes medicines might harm the heart, but this new study shows that “there are now newer drugs available that have beneficial cardiovascular effects.”
Grines noted that fluid buildup is a hallmark of heart failure. And because Farxiga “works by increasing the excretion of glucose in urine, it is not surprising that it reduces heart failure.”
However, she found it surprising that the drug didn’t lower rates of heart attack or stroke.
The common diabetes drug metformin has been shown to lower the risk for these cardiac events, however. So, “I would chose [Farxiga] to add to metformin in patients with congestive heart failure,” Grines added.
According to Grines, patients with heart issues should avoid one class of diabetes drugs in particular.
“Multiple studies have shown that sulfonylurea drugs — glipizide, glyburide and glimepiride — increasedcardiovascular mortality, heart attack and congestive heart failure” she said, “so sulfonylureas should be avoided in all cardiac patients.”
Another heart specialist agreed that newer medicines such as Farxiga are improving treatment for people with type 2 diabetes.
Farxiga is “a welcomed addition to our armamentarium to reduce heart failure,” said Dr. Marcin Kowalski, a cardiologist at Staten Island University Hospital in New York City. “It is also uplifting that this group of medications did not increase [negative] cardiovascular outcomes.”WebMD News from HealthDay
SourcesSOURCES: Cindy Grines, M.D., chair, cardiology, North Shore University Hospital, Manhasset, N.Y., and Long Island Jewish Medical Center, New Hyde Park, N.Y.; Marcin Kowalski, M.D., cardiologist, Staten Island University Hospital, New York City; Brigham and Women’s Hospital, news release, Nov. 10, 2018
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