SGLT2 inhibitors show significant promise in the treatment of heart failure regardless of how long a patient has had type 2 diabetes, as per a new meta-analysis presented at the European Society of Cardiology (ESC) Congress.
At the ESC congress, held from 30 August to 2 September, Dr. Jawad Haider Butt, a research fellow at the University of Glasgow’s British Health Foundation Cardiovascular Research Centre, presented data surrounding the use of SGLT2 inhibitors in patients with heart failure and type 2 diabetes.
Despite an industry conception that patients with long-standing type-2 diabetes may be less likely to tolerate and benefit from new treatments, a pooled meta-analysis of AstraZeneca’s DAPA-HF Phase III trial (NCT03036124) and the Phase III DELIVER trial (NCT03619213), investigating Forxiga (dapagliflozin propanediol), showed that the benefit of Forxiga or Farxiga on the primary outcome was consistent across patients with different type 2 diabetes durations. Furthermore, treatment with Forxiga had a consistent benefit on the worsening of heart failure across type 2 diabetes patients.
The pairing of type 2 diabetes and heart failure can be fairly common in patients, explained Butt. Several companies pursue drug development in the two indications due to their overlapping pathogenesis. For example, in 2014, the US Food and Drug Administration first approved Forxiga for the treatment of type 2 diabetes. AstraZeneca has since received approvals for the drug in other metabolic indications, like heart failure with reduced ejection fraction in 2020.
Other SGLT2 inhibitor drugs such as Johnson and Johnson’s Invokana (canagliflozin) and Boehringer Ingelheim and Eli Lilly’s Jardiance (empagliflozin) are also marketed for the treatment of heart failure and type 2 diabetes in the US. The class of drugs has made a major impact on the heart failure treatment landscape in recent years, amassing significant sales for each company.
In a Q2 financial report, Eli Lilly shared that its US revenue from Jardiance reached $428.9m during the quarter. Furthermore, a 2023 annual financial report labelled Forxiga as AstraZeneca’s best-selling drug that year, making $5.96bn in global sales.
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