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April 13, 2021
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DAPA-HF: Dapagliflozin improves worsening HF, CV death similarly in men, women

Dapagliflozin is equally as effective in women as in men in reducing risk for worsening HF, CV death and all-cause death compared with placebo, according to new data from the DAPA-HF trial.

Dapagliflozin reduced the risk of worsening heart failure and death and improved symptoms, physical function and health-related quality of life similarly in men and women with heart failure and reduced ejection fraction,” Jawad H. Butt, MD, research fellow in the department of cardiology at Rigshospitalet at Copenhagen University Hospital in Denmark, and colleagues wrote.

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As Healio previously reported, in the main results of DAPA-HF, dapagliflozin (Farxiga, AstraZeneca) reduced risk for worsening HF and CV death when added to standard therapy in patients with HFrEF regardless of whether they had diabetes.

For the current study, researchers analyzed 4,744 patients (23.4% women) with HFrEF.

Researchers found that dapagliflozin reduced risk for worsening HF or CV death compared with placebo similarly in men and women (HR in men = 0.73; 95% CI, 0.63-0.85; HR in women = 0.79; 95% CI, 0.59-1.06; P for interaction = .67).

The treatment effect of dapagliflozin was similar in both sexes for all secondary outcomes, including all-cause death, Butt and colleagues wrote.

According to the researchers, compared with men, women had lower risk for worsening HF or CV death (adjusted HR = 0.72; 95% CI, 0.61-0.85) and worsening HF, CV death and episodes of outpatient worsening (aHR = 0.8; 95% CI, 0.69-0.92).

“Women had a lower risk of these outcomes compared with men, even after adjustment for other prognostic variables, including left ventricular EF and N-terminal pro-B-type natriuretic peptide,” Butt and colleagues wrote.

In both sexes, dapagliflozin compared with placebo increased the proportion of patients with meaningfully improved symptoms and decreased the proportion with worsening symptoms, according to the researchers.

“These findings provide further support for dapagliflozin as a new treatment option for patients with HFrEF,” the researchers wrote.