Dapagliflozin (Farxiga; AstraZeneca) eases symptoms and physical limitations among patients who have heart failure with preserved ejection fraction (HFpEF) within a relatively short time period, the PRESERVED-HF trial shows, adding to recent evidence supporting the benefits of sodium-glucose cotransporter 2 (SGLT2) inhibition in this difficult-to-treat population.

After 12 weeks of treatment, improvement in the Kansas City Cardiomyopathy Questionnaire (KCCQ) clinical summary score was 5.8 points greater in patients treated with dapagliflozin versus placebo (P = 0.001), Mikhail Kosiborod, MD (Saint Luke’s Mid America Heart Institute, Kansas City, MO), reported Sunday at the Heart Failure Society of America 2021 meeting in Denver, CO.

“The effect was large, clinically meaningful, and statistically significant,” he said, noting that the finding was consistent across key subgroups defined by diabetes status, baseline LVEF, and other variables. “PRESERVED-HF, to our knowledge, is the first trial to demonstrate that [the] SGLT2 inhibitor dapagliflozin significantly improves symptoms, physical limitations, and 6-minute walking distance in patients with HFpEF,” Kosiborod said.

The results, which are in press in Nature Medicine, complement those from large trials focused on clinical outcomes, he said, “and collectively support the use of SGLT2 inhibitors as a new treatment option in HFpEF, which is a morbid condition with few therapeutic options. This, in our opinion, should have implications for clinical practice.”

Read the rest of the TCTMD article: PRESERVED-HF: Dapagliflozin Improves Symptoms, Physical Limitations in HFpEF