Clinical takeaway
For appropriately selected patients, dapagliflozin's value extends across heart failure and kidney disease, including in many people without diabetes.
A cardiorenal medicine
Dapagliflozin is an SGLT2 inhibitor whose evidence base extends beyond glucose lowering. Major trials have shown reductions in worsening heart failure, cardiovascular death, and kidney-disease progression across several patient groups.
Evidence highlights
- DAPA-HF: 26% relative risk reduction in worsening heart failure or cardiovascular death.
- DAPA-CKD: 39% relative risk reduction in the primary kidney composite.
- DELIVER: 18% relative risk reduction in worsening heart failure or cardiovascular death.
- Benefits in DAPA-CKD were consistent in the non-diabetic subgroup.
At the bedside
Consider volume status, renal function, genital mycotic infection risk, and rare serious adverse events. Use current product information and local guidance when prescribing.
References
- McMurray JJV, et al. N Engl J Med. 2019;381:1995-2008.
- Heerspink HJL, et al. N Engl J Med. 2020;383:1436-1446.
- Solomon SD, et al. N Engl J Med. 2022;387:1089-1098.
Educational summary from Medeasy Review Issue 01. Verify recommendations against current guidelines, local approvals, product information, and the individual patient's circumstances.
