Effect of Dapagliflozin in Lowering Risk of Heart Failure Severity: Meta-Analysis

Authors

  • Andreza Andreza Faculty of Medicine, Universitas Hasanuddin, Makasar
  • Anis Nur Widayati Faculty of Dentistry, Universitas Muhammadiyah Surakarta

DOI:

https://doi.org/10.26911/jepublichealth.2023.08.01.03

Abstract

Background: Heart failure is a progressive health problem with high mortality and morbidity rates in developed as well as developing countries including Indonesia. Dapagliflozin is one of the oral antidiabetic medicines of the class of sodium-glucose cotransporter-2 (SGLT2) inhibitors, used in people with type 2 diabetes mellitus (DMT2). Unlike other oral anti-diabetes that work to stimulate insulin secretion or increase insulin sensitivity, dapagliflozin works in the kidneys by competitively inhibiting the SGLT2 protein reversibly which serves in glucose reabsorption in the glomerulus thereby lowering blood sugar levels in T2DM patients. This study aimed to determine the estimated effect of dapagliflozin on the severity of heart failure patients.
Subjects and Method: This study was a systematic review and meta-analysis with PICO. Population= Heart failure patients over 18 years old. Intervention= administration of dapagliflozin. Comparison= Placebo. Outcome= severity of Heart Failure. The articles used PRISMA flowchart guidelines. The article search process was conducted from 2019 to 2022 using databases from PubMed, Google Scholar, and Scopus with the search keywords Dapagliflozin, Heart Failure, and Placebo. The analysis was performed using RevMan 5.4 software.
Results: A total of 8 articles from across 2 continents, America and Asia, reviewed in the meta-analysis, showed that administering Dapagliflozin could reduce the risk of heart failure severity by 0.99 units compared to without dapagliflozin, however, it was statistically insignificant (OR= 0.99; 95% CI= 0.92 to 1.06; p= 0.710).
Conclusion: The administration of Dapagliflozin lowers the risk of heart failure severity and is statistically significant.

Keywords: dapagliflozin, heart failure, placebo

Correspondence: Andreza. Universitas Hasanuddin. Jl. Perintis Kemerdekaan No.KM.10, Tamalanrea Indah, Kec. Tamalanrea, Makasar City, South Sulawesi. Email: andrezafauzialghifary@gmail.com. Mobile: +625299015320.

References

Adamson C, Jhund, PS, Docherty KF, Belohlávek J, Chiang C-E, Diez M, Drozḋ ż J, et al. (2021). Efficacy of dapagliflozin in heart failure with reduced ejection fraction according to body mass index. Eur Heart J Title(s). 23: 1662–1672. doi: 10.1002/ejhf.2308.

Bhatt DL, Szarek M, Pitt B, Cannon CP, Leiter LA, McGuire DK, Lewis JB, et al. (2021). Sotagliflozin in Patients with Diabetes and Chronic Kidney Disease. N Engl J Med. 384: 129-139. doi: 10.1056/NEJMoa2030186.

Boulton DW, Kasichayanula S, Keung CF, Arnold ME, Christopher LJ, Xu XS (2013). Simultaneous oral therapeutic and intravenous C-microdoses to determine the absolute oral bioavailability of saxagliptin and dapagliflozin. Br J Clin Pharmacol. 75: 763-768. doi: 10.1111/j.1365-2125.2012.04391.x.

Butt JH, Docherty KF, Jhund PS, Boer RA, Böhm M, Desai AS, Howlett JG, et al. (2022). Dapagliflozin and atrial fibrillation in heart failure with reduced ejection fraction: insights from DAPA-HF. Eur J Heart Fail. 24: 513–525. doi: 10.1002/ejhf.2381.

Butt JH, Nicolau JC, Verma S, Docherty KF, Petrie MC, Inzucchi SE, Schou M, et al. (2021). Efficacy and safety of dapagliflozin according to aetiology in heart failure with reduced ejection fraction: insights from the DAPA-HF trial. Eur J Heart Fail. 23: 601–613. doi: 10.1002/ejhf.2124.

Docherty KF, Ogunniyi MO, Anand IS, Desai AS, Diez M, Howlett JG, Nicolasz JC, et al. (2022). Efficacy of Dapagliflozin in Black Versus White Patients with Heart Failure and Reduced Ejection Fraction. JACC Heart Fail. 10: 52-64. doi: 10.1016/j.jchf.2021.08.006.

Docherty KF, Jhund PS, Inzucchi S, Køber L, Kosiborod MN, Martinez FA, Poni-kowski P, et al. (2020). Effects of dapagliflozin in DAPA-HF according to background heart failure therapy. Eur Heart J. 41: 2379–2392. doi: 10.1093/eurheartj/ehaa183.

Hersunarti NSB, Erwinanto, Nauli SE, Lubis AC, Wiryawan IN, Dewi PP, Pratikto RS, Hasanah DY (2020). Pedoman Tatalaksana Gagal Jantung. PERKI. 2.

Inzucchi SE, Docherty KF, Køber L, Kosibo-rod MN, Martinez FA, Ponikowski P, Sabatine M S, et al. (2021). Dapagliflozin and the Incidence of Type 2 Diabetes in Patients with Heart Failure and Reduced Ejection Fraction: An Exploratory Analysis From DAPA-HF. Diabetes Care. 44: 586-594. doi: 10.2337/dc20-1675.

Kosiborod MN, Jhund PS, Docherty KF, Diez M, Petrie MC, Verma S, Nicolau JC, Mekley B, et al. (2020). Effects of Dapagliflozin on Symptoms, Function, and Quality of Life in Patients with Heart Failure and Reduced Ejection Fraction. Circulation. 141:90-99. doi: 10.1161/CIRCULATIONAHA.119.044138.

McMurray JJV, Solomon SD, Inzucchi SE, Køber L, Kosiborod MN, Martinez FA, Ponikowski P, et al. (2019). Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 1: 1-13. doi: 10.1056/NEJMoa1911303.

Nassif ME, Windsor SL, Tang F, Khariton Y, Husain M, Inzucchi SE, McGuire DK, et al. (2019). Dapagliflozin Effects on Biomarkers, Symptoms, and Functional Status in Patients with Heart Failure with Reduced Ejection Fraction: The DEFINE-HF Trial. Circulation. 140: 1463-1476. doi: 10.1161/CIRCULA-TIONAHA.119.042929

Packer M, Anker SD, Butler J, Filippatos G, Ferreira JP, Pocock SJ, Carson P, et al. (2021). Effect of Empagliflozin on the Clinical Stability of Patients with

Heart Failure and a Reduced Ejection Fraction: The EMPEROR-Reduced Trial. Circulation. 143: 326-336. doi: 10.1161/CIRCULATIONAHA.120.051783. Epub 2020 Oct 21.

Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM, Edwards R, et al. (2019). Canagliflozin and Renal Outcomes in Type 2 Dia-betes and Nephropathy. N Engl J Med. 380: 2295-2306. doi: 10.1056/NEJMoa1811744.

Petrie MC, Verma S, Docherty KF, Inzucchi SE, Anand I, Bělohlávek J, Böhm M, et al. (2020). Effect of Dapagliflozin on Worsening Heart Failure and Cardiovascular Death in Patients with Heart Failure with and Without Diabetes. JAMA. 1: 1-10. doi: 10.1001/ja-ma.2020.1906.

Zelniker TA, Wiviott SD, Raz I, Im K, Good-rich EL, Bonaca MP, Mosenzon O, et al. (2019). SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. Lancet. 393: 31-39. doi: 10.1016/S0140-6736(18)32590X.

Zinman B, Wanner C, Lachin JM, Fitchett D, Bluhmki E, Hantel S, Mattheus M, et al. (2015). Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 373: 2117-2128. doi: 10.1056/NEJMoa150-4720.

Downloads

Published

2023-01-16

How to Cite

Andreza, A., & Widayati, A. N. (2023). Effect of Dapagliflozin in Lowering Risk of Heart Failure Severity: Meta-Analysis. Journal of Epidemiology and Public Health, 8(1), 25–34. https://doi.org/10.26911/jepublichealth.2023.08.01.03

Issue

Section

Articles