Diabetes medication for heart failure
According to experts, more and more people in Germany suffer from heart failure. According to the current state of medicine, the disease is not yet curable, but it is well treatable. The treatment is intended to slow down the progression of the disease and improve the symptoms so that an active life remains possible. It is now reported that two drugs that have been developed for the treatment of diabetes are also effective against heart failure.
The chronic one Heart failure, also known as heart failure, is one of the most common diseases in Western countries. In Germany alone, the number of those affected is estimated at two to three million. Their quality of life is often extremely limited. If left untreated, the disease can be fatal. But now there is reason for hope: in scientific studies, the effectiveness of two drugs that were actually developed for the treatment of diabetes has been proven against heart failure.
Like the German Society for Cardiology – Heart and Circulatory Research eV (DGK) in one Message explains, chronic heart failure usually develops as a result of other cardiovascular diseases such as high blood pressure, coronary heart disease (CHD) and especially after heart attacks or myocarditis. In addition, some forms of heart muscle disease (genetic cardiomyopathies) have a genetic predisposition.
Although efficient drugs for treating heart failure and, above all, the underlying diseases have been developed in recent years, mortality and hospital admissions have remained high.
New study data are now drawing the attention of cardiologists to the drugs dapagliflozin and empagliflozin from the group of SGLT 2 inhibitors originally developed for diabetes mellitus.
After some oral diabetes drugs caused increases in hospital admissions because of worsening heart failure in the past, the US Food and Drug Administration (FDA) made safety studies mandatory for all newly developed anti-diabetic drugs. According to the DGK, approval studies on SGLT2 inhibitors showed that they not only help with diabetes, but also seem to improve heart failure.
Decrease in the risk of death
According to the experts, the class of SGLT2 inhibitors inhibits the reuptake of glucose from the so-called primary urine back into the blood. This then leads to a loss of glucose and thus to a lowering of blood sugar.
However, the substances not only lead to a loss of glucose via the kidneys, but also to a loss of sodium and metabolic changes that could be energetically beneficial for the heart.
These were large, multicenter studies with a total of more than 8,000 patients, who were treated double-blind and randomized. Interestingly, heart failure patients with impaired ventricular function with and without diabetes were included.
All study participants continued to receive optimal standard therapy for cardiac insufficiency. Both studies consistently showed a decrease in the risk of cardiovascular death and heart failure hospital admissions of about 25 percent. The effects in both studies were independent of modern concomitant therapy and were comparable in patients with and without diabetes mellitus.
The kidney function is also improved
“The consistent decrease in heart failure complications in diabetics and non-diabetics in the studies is impressive,” says Prof. Dr. Michael Böhm, press spokesman for the DGK and scientific director of both studies for Germany. “This shows that an efficient heart failure drug can evolve from a diabetes drug, as evidenced by its effectiveness in non-diabetics.”
DGK President Prof. Dr. Andreas Zeiher adds: “These study results are really good news for all patients with cardiac insufficiency. So far, no other drug has shown such convincing results, especially because the kidney function is significantly improved at the same time. “
Böhm’s conclusion is that the SGLT2 inhibitors will most likely be included with a strong recommendation in the European guidelines for the diagnosis and treatment of heart failure, which will appear in 2021. This guideline is currently being prepared by an international committee of experts. (ad)
Author and source information
This text complies with the requirements of specialist medical literature, medical guidelines and current studies and has been checked by medical professionals.
- German Society for Cardiology – Heart and Circulatory Research eV (DGK): With diabetes drugs against heart failure, (accessed: 22.09.2020), German Society for Cardiology – Heart and Circulatory Research eV (DGK)
- Milton Packer, M.D., Stefan D. Anker, M.D., Ph.D., Javed Butler, M.D., Gerasimos Filippatos, M.D., Stuart J. Pocock, Ph.D., Peter Carson, M.D., James Januzzi, M.D., Subodh Verma, M.D., Ph.D., Hiroyuki Tsutsui, M.D., Martina Brueckmann, M.D., Waheed Jamal, M.D., Karen Kimura, Ph.D., et al.: Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure; in: The New England Journal of Medicine, (veröffentlicht: 29.08.2020), The New England Journal of Medicine
- John J.V. McMurray et al.: Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction; in: The New England Journal of Medicine, (veröffentlicht: 05.03.2020), The New England Journal of Medicine
This article is for general guidance only and should not be used for self-diagnosis or self-treatment. He can not substitute a visit at the doctor.