medwireNews: Dapagliflozin treatment significantly improves self-reported symptoms, physical function, and quality of life in people who have heart failure with reduced ejection fraction (HFrEF), report the DAPA-HF investigators.
“These effects were substantial,” say Mikhail Kosiborod (Saint Luke’s Mid America Heart Institute, Kansas City, Missouri, USA) and co-researchers, with the numbers needed to treat ranging from 12 to 18 after 8 months of treatment.
They stress that the improvements seen with dapagliflozin treatment “compare favorably with other efficacious therapies for HFrEF.”
A total of 4443 trial participants (93.7% of the whole DAPA-HF population) had data available for the 23-item Kansas City Cardiomyopathy Questionnaire (KCCQ) at baseline. Of these 4141 had data available at 4 months and 3955 did so at 8 months. The tool measures heart failure symptoms, physical function, and quality of life over the preceding 2 weeks.
After 4 months of follow-up, people taking dapagliflozin had “modest, but significant” improvements in KCCQ scores compared with those taking placebo, at 1.9, 1.8, and 1.7 points higher for total symptom score, clinical summary score, and overall summary score, respectively.
These improved further by 8 months of follow-up, to be a corresponding 2.8, 2.5, and 2.3 points higher in the dapagliflozin versus placebo groups.
In addition, the researchers say that significantly fewer patients in the dapagliflozin versus placebo groups had clinically meaningful deterioration (25.3 vs 32.9%), and significantly more achieved clinically meaningful improvements in health status.
“Given the importance of reducing symptom burden and functional limitations and improving the quality of life – a key goal of HF management endorsed by the practice guidelines and regulators – our findings provide further support for dapagliflozin as a new treatment option for patients with HFrEF,” writes the team in Circulation.
The researchers also report that having poor function and life quality at baseline did not impact the efficacy of dapagliflozin, despite worse outcomes overall.
People who had poorer KCCQ scores at baseline had higher rates of the primary clinical endpoint (cardiovascular death or worsening heart failure) during the median 18.2 months of follow-up. The rates were 25.0%, 17.3%, and 13.6% for those in the lowest, middle, and highest tertiles of KCCQ scores, respectively.
But all groups benefited from treatment with dapagliflozin 10 mg/day, with corresponding relative risk reductions for the primary endpoint of 30%, 27%, and 38% compared with placebo treatment.
This shows “that the beneficial effects of dapagliflozin on HF outcomes are independent of the health status impairment at baseline,” say Kosiborod and team.
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