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Farxiga Helpful for Anyone With Heart Failure

Published: 9/6/22
By Arvind Sommi

Transparent image of human body showing internal organs with a restricted artery Impressive results from the DELIVER trial show that dapagliflozin (Farxiga), a SGLT-2 inhibitor, could be used to treat all types of heart failure, a common diabetes complication. Read more about the significance of this trial.

The DELIVER clinical trial demonstrated that, compared to placebo, people with heart failure who took dapagliflozin (Farxiga) experienced an 18% relative reduction in the risk for hospitalization and death.

Diabetes and heart failure

People with type 2 diabetes are 2-4 times more likely to experience heart failure, one of the most common complications of diabetes. Heart failure occurs when the heart cannot pump enough blood to the rest of your body. There are several different types of heart failure, including:

  1. Heart failure with reduced ejection fraction (HFrEF) – HFrEF occurs when heart muscle becomes weak and can only pump out less than 40% of the blood from the left ventricle, the most important heart chamber.

  2. Heart failure with mildly-reduced ejection fraction (HFmrEF) – HFmrEF occurs when the heart pumps out between 40% - 50% of the blood from the left ventricle.

  3. Heart failure with preserved ejection fraction (HFpEF) – HFpEF usually occurs when the left ventricle loses the ability to relax normally because the muscle has become stiff. The heart can't properly fill with blood during the resting period between each heartbeat, However, it can pump more than 50% of the blood from the left ventricle. HFpEF is commonly associated with high blood pressure, type 2 diabetes, obesity, and kidney disease. 

  4. Heart failure with improved ejection fraction (HFimpEF) – HFimpEF occurs when cardiac function increases with treatment from HFrEF to HFmrEF or HFpEF.

The diagram below clarifies this information:

chart showing levels of ejection fraction

Why is the DELIVER trial important?

The DELIVER trial included participants with heart failure who did not have a reduced left ventricular ejection fraction (LVEF ≤40%; HFrEF), including those with and without type 2 diabetes. The trial confirms the previous findings of the EMPEROR-Preserved trial that found empagliflozin (Jardiance) achieved similar results in this group of participants with heart failure.

However, DELIVER is unique because it included participants with HFmrEF, HFpEF as well as HFimpEF, and together with earlier trials, showed improvement for participants with any type of heart failure – with or without diabetes.

Additionally, the DELIVER trial results were consistent in participants from outpatient settings and those enrolled during or within 30 days of hospitalization. These findings suggest many people with diabetes and heart failure, whether or not they have diabetes, should consider starting a SGLT-2 inhibitor, like dapagliflozin, immediately upon diagnosis of heart failure, including while in the hospital – even before the ejection fraction is measured since it is effective in any type of heart failure regardless of cardiac function.

To learn more about heart failure, consider reading our other articles:

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About the authors

Arvind Sommi joined the diaTribe Foundation in 2021 after graduating from the University of Florida with a degree in Biology . Arvind Sommi joined the diaTribe Foundation in 2021 after... Read the full bio »