Page 95 - Pharma News Letter - Vol2 Issue 1

Research Publications

The Clinical Outcomes Of Dapagliflozin In Patients With Acute Heart
Failure: A Randomized Controlled Trial (Dapa-Response-Ahf)

European Journal Of Pharmacology. 2023 Dec; 961: 176179.
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Abdelrahman N Emara 1, Moheb Wadie 2, Noha O Mansour 1,3, Mohamed E E Shams 1

1 Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Mansoura University, Mansoura,
35516, Egypt.

2 Cardiology Department, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt.
3 Clinical Pharmacy and Pharmacy Practice Department, Faculty of Pharmacy, Mansoura National University,

Egypt.

Abstract

Aims: Dapagliflozin may confer additional decongestive and natriuretic benefits to patients with
acute heart failure (AHF). Nonetheless, this hypothesis was not clinically examined. This study
aimed primarily to investigate the effect of dapagliflozin on symptomatic relief in those patients.
Methods: This was a randomized, double-blind study that included 87 patients with AHF
presenting with dyspnea. Within 24 h of admission, patients were randomized to receive either
dapagliflozin (10 mg/day, N = 45) or placebo (N = 42) for 30 days. The primary outcome was the
difference between the two groups in the area under the curve (AUC) of visual analogue scale
(VAS) dyspnea score over the first 4 days. Secondary endpoints included urinary sodium (Na)
after 2 h of randomization, percent change in NT-proBNP, cumulative urine output (UOP), and
differences in mortality and hospital readmission rates.
Results: The results showed that dapagliflozin significantly reduced the AUC of VAS dyspnea
score compared to placebo (3192.2 ± 1631.9 mm × h vs 4713.1 ± 1714.9 mm × h, P < 0.001).
The relative change of NT-proBNP compared to its baseline was also larger with dapagliflozin
(-34.89% vs -10.085%, P = 0.001).Additionally, higher cumulative UOP was found at day 4 (18600
ml in dapagliflozin vs 13700 in placebo, P = 0.031). Dapagliflozin decreased rehospitalization
rates within 30 days after discharge, while it did not affect the spot urinary Na concentration,
incidence of worsening of heart failure, or mortality rates.
Conclusion: Dapagliflozin may provide symptomatic relief and improve diuresis in patients
with AHF. Further studies are needed to confirm these findings.

Reference:

https://doi.org/10.1016/j.ejphar.2023.176179

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