Efficacy and safety of dapagliflozin in the treatment of chronic heart failure

Background. Dapagliflozin is a drug from the group of type 2 sodium-dependent glucose transporter inhibitors (iNGLT2) and was previously intended only for the treatment of type 2 diabetes mellitus as monotherapy or combination therapy. According to the Clinical Guidelines, dapagliflozin is recommended for patients with chronic heart failure with reduced ejection function with persistent symptoms of heart failure despite therapy with ACE inhibitors, angiotensin II receptor anagonists, valsartan and sacubitril combination, beta-adrenoblockers and aldosterone antagonists to reduce the risk of cardiovascular death and hospitalizations for heart failure. Aims — comparative analysis of the efficacy of dapagliflozin in the treatment of chronic heart failure with reduced and preserved ejection function according to clinical trials data. Methods. Data from clinical trials of dapagliflozin efficacy in the treatment of CHF with reduced and preserved ejection fraction and including analysis of treatment data from 4744 and 6263 patients, respectively, served as materials for comparative analysis. The analysis was performed by statistically evaluating dapagliflozin for the primary endpoint (hospitalization for heart failure, seeking emergency care for heart failure) and for the total number of hospitalizations and cardiovascular deaths. Attribute statistics techniques were used as an analytical tool. Information on potential drug interactions was obtained from the specialized website Drugs.com. Results. The attributable efficacy for reduction in total hospitalizations and cardiovascular deaths for dapagliflozin was 7.72% (95% CI: 5.45–9.99) for patients with CHF with preserved ejection fraction and 7.40% (95% CI: 4.86–9.94). This rate is statistically significant for both groups. The population attributable efficacy rate was also statistically significant for both groups. The relative efficacy of dapagliflozin in reducing total hospitalizations and cardiovascular deaths was 1.12 (95% CI: 0.11–2.12) for patients with CHF with preserved ejection fraction and 1.11 (95% CI: 0.10–2.11) for patients with CHF with reduced ejection fraction. According to Drugs.com, 352 potential adverse interactions were identified for dapagliflozin, of which 1 was a dangerous clinical interaction. Conclusions. Dapagliflozin is an LP for which studies have been shown statistically significant reductions in total hospitalizations of patients with cardiovascular disease and cardiovascular deaths.