Research

DAPA-HF: Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure

DAPA-HF, a landmark trial, ran from February 2017 to July 2019, with Professor John McMurray at the helm as Chief Investigator. This was the first outcomes trial with an SGLT2 inhibitor investigating the treatment of heart failure in patients with reduced ejection fraction (HFrEF) with and without type 2 diabetes, and was sponsored by AstraZeneca.

Results were announced on 1 September at the European Society of Cardiology (ESC) Congress in Paris and were well received to rapturous applause from the audience of experts. Papers have been published in European Journal of Heart Failure, New England Journal of Medicine, European Heart Journal and Circulation. The trial concluded that Dapagliflozin – a drug normally used for treating type 2 diabetes – (when added to standard therapy) reduced both the incidence of cardiovascular death and the worsening of heart failure, and was as effective in heart failure patients without diabetes as in those with diabetes. With advancing patient care being at the heart of everything we do, Dapagliflozin offers a new approach to the treatment of heart failure patients with reduced ejection fraction.

Chief Investigator         

• John J.V. McMurray

Co-Investigators            

• Scott D. Solomon, M.D., 
• Silvio E. Inzucchi, M.D., 
• Lars Køber, M.D., D.M.Sc., 
• Mikhail N. Kosiborod, M.D., 
• Felipe A. Martinez, M.D., 
• Piotr Ponikowski, M.D., Ph.D., 
• Marc S. Sabatine, M.D., M.P.H., 
• Inder S. Anand, M.D., 
• Jan Bělohlávek, M.D., Ph.D., 
• Michael Böhm, M.D., Ph.D.,
• Chern-En Chiang, M.D., Ph.D

Trial Co-Ordinator         

PUBLICATION:

https://www.nejm.org/doi/full/10.1056/NEJMoa1911303

TRIAL:

https://clinicaltrials.gov/ct2/show/NCT03036124

PI:

Prof John McMurray  

SCMH NEWS - https://www.gla.ac.uk/schools/cardiovascularmetabolic/newsandevents/march-may2020/headline_725046_en.html

MVLS NEWS - https://www.gla.ac.uk/news/archiveofnews/2019/september/headline_669254_en.html

DAPA_HF: https://www.nejm.org/doi/full/10.1056/NEJMoa1911303

MAY 2020

Estimating the cumulative survival advantage of the 3 newest life-saving treatments in Heart Failure - each shown to be of benefit in trials the HF group were involved in leading.

Estimating lifetime benefits of comprehensive disease-modifying pharmacological therapies in patients with heart failure with reduced ejection fraction: a comparative analysis of three randomised controlled trials
Online - https://www.sciencedirect.com/science/article/pii/S0140673620307480#!

MARCH 2020

The American College of Cardiology Congress –Virtual, included presentations and posters from the HF group, 

• Including an excellent poster by Dr Stephen Dobbin and Dr Ninian Lang:
  
  Can be viewed online here:World congress of cardiology - VIRTUAL - poster
• On demand presentation by Dr Kieran Docherty
  
  Title: CONSISTENT BENEFIT OF DAPAGLIFLOZIN ACCORDING TO BACKGROUND THERAPY IN PATIENTS WITH HFREF: AN ANALYSIS OF THE DAPA-HF TRIAL.
  Presentaton can be viewed online here: World congress of cardiology - presentation
  
  There were also a number of simultaneous publications in the major journals including JAMA and the European Heart Journal. 

1. Effect of Dapagliflozin on Worsening Heart Failure and Cardiovascular Death in Patients With Heart Failure With and Without Diabetes. view online here:  https://jamanetwork.com/journals/jama/fullarticle/2763950
2. Effects of dapagliflozin in DAPA-HF according to background heart failure therapy. View online here: https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehaa183/5813081

NOV 2019

1. Efficacy and Safety of Dapagliflozin in Heart Failure With Reduced Ejection Fraction According to Age.
   Insights From DAPA-HF
   Felipe A Martinez, Matteo Serenelli, Jose C Nicolau, Mark C Petrie, Chern-En Chiang, Sergey Tereshchenko, Scott D Solomon, Silvio E Inzucchi, Lars Køber, Mikhail N Kosiborod, Piotr Ponikowski, Marc S Sabatine, David L DeMets, MonikaDutkiewicz-Piasecka, OlofBengtsson, Mikaela Sjöstrand, Anna Maria Langkilde, Pardeep S Jhund, John J V McMurray.
   
   Circulation - https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.119.044133
   
   
2. Effects of dapagliflozin on symptoms, function and quality of life in patients with heart failure and reduced ejection fraction: results from the DAPA-HF Trial.
   Mikhail N Kosiborod, Pardeep S Jhund, Kieran F Docherty, Mirta Diez, Mark C Petrie, Subodh Verma, Jose C Nicolau, Béla Merkely, Masafumi Kitakaze, David L DeMets, Silvio E Inzucchi, Lars Køber, Felipe A Martinez, Piotr Ponikowski, Marc S Sabatine, Scott D Solomon, Olof Bengtsson, Daniel Lindholm, Anna Niklasson, Mikaela Sjöstrand, Anna Maria Langkilde, John J V McMurray.  
   
   Circulation - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.119.044138

SEPT 2019

The late breaking results of the DAPA-HF trial were presented in a Hot Line Session at ESC Congress 2019 together with the World Congress of Cardiology.

#IMAGE

Principal investigator Professor John McMurray said: “The most important finding of all is the benefit in patients without diabetes. This is truly a treatment for heart failure and not just a drug for diabetes.”