The clinical value and meaning of’DAPA-HF study’ for chronic heart failure treatment
More than half of heart failure patients died within 5 years… Demand for New Treatment Options Unmet
Decreased heart failure, cardiovascular death risk by 26%… Contributing to improving the quality of life
Chronic heart failure disease has a high patient burden and a high mortality rate as it can be said to be the end of heart disease. The disease is difficult to improve, and repeated hospitalization and discharge has a significant impact on the quality of life of patients. In addition, the number of patients is expected to increase further as we enter the ultra-aged society.
In December of last year, the first SGLT-2 inhibitor-based type 2 diabetes treatment was prepared to examine the clinical significance of’Possiga’ (ingredient name: dapagliflozin), which added an indication for treating chronic heart failure.
On the 25th, AstraZeneca Korea held an online conference to introduce the clinical value and efficacy of Posiga’s heart failure treatment, confirmed through the DAPA-HF study.
The meeting was held by Choi Dong-ju, president of the Korean Heart Failure Society (Professor of Seoul Medical University, Seoul National University Bundang Hospital), and Professor Jin-oh Choi (Research Director of the Department of Cardiology and Korean Heart Failure Society, Samsung Seoul Hospital),’Introduction of Heart Failure Diseases and Treatment Goals’, Professor Seong-Hoon Choi (Academic Director of Cardiovascular Internal Medicine, Gangnam Cardiology Hospital, Korean Society of Heart Failure),’Efficacy and Safety of Posiga’s Heart Failure Treatment Through the DAPA-HF Study’, Professor Kim Eung-ju, Korea Medical University (Cardiovascular Center, Korea Daeguro Hospital, General Secretary of the Korean Heart Failure Association) Director) led to a series of presentations such as’Management of Concomitant Diseases for Heart Failure Patients’ and Q&A.
Prof. Jin-oh Choi cited the prevention of hospitalization and reduction of mortality rate, management of comorbid diseases and improvement of clinical condition, improvement of patient’s function range and quality of life as considerations for heart failure treatment, as the prevalence and medical cost of heart failure in Korea continues to rise. He stressed the importance of applying the optimal treatment.
Professor Choi said, “Despite standard treatment, the survival rate is low enough that more than half of the patients diagnosed with heart failure die within 5 years, and efforts are needed to further reduce the death and hospitalization rates due to heart failure and reduce medical costs.” He expressed his expectations for the option.
The awareness of heart failure treatment was also raised.
Professor Choi said, “When you first visit the hospital for symptoms of heart failure, such as shortness of breath, using only diuretics can improve the symptoms. However, even if the symptoms improve, the disease eventually progresses. Appropriate treatment should be provided so that the disease does not progress. It is necessary to recognize that the progress can be improved after receiving the patient. In addition, it is necessary to increase the awareness of the heart failure disease so that the patient has more opportunities to receive treatment.” He added, “I hope you will pay more attention to the hospital. If you see abnormal findings such as X-rays or electrocardiograms, you should suspect heart failure. BNP blood tests using biomarkers are also useful. You should also inform the diagnosis method.”
Prof. Seong-Hoon Choi, who was in charge of the second presentation, said that Posiga confirmed the benefits of hospitalization for heart failure and preventing cardiovascular death in the DECLARE study of type 2 diabetes patients. It was emphasized that deaths from cardiovascular disease or worsening of heart failure were reduced in patients with reduced chronic heart failure.
Prof. Choi said, “Among the results of the DAPA-HF study, the most significant part of this study is that the risk of death from worsening heart failure and cardiovascular disease was reduced by 26% in patients already receiving standard treatment for heart failure.” In a study evaluating the improvement of symptoms and quality of life through the results, Fossiga improved the KCCQ (Kansas City Cardiomyopathy Questionnaire, University of Kansas Cardiomyopathy Questionnaire) score.”
Professor Choi said, “Regardless of the presence of diabetes, standard heart failure treatment is maintained stably in patients with left ventricular ejection rate heart failure (HFrEF), and in patients with added dapagliflozin, cardiovascular accidents and heart failure readmissions as well as mortality are reduced. Was confirmed, and adverse reactions caused by drug use did not increase, and were used safely.”
It is pointed out that the use of SGLT2 inhibitors is recommended for patients with recent cardiovascular disease or high-risk patients with diabetes, and is strongly recommended as a major drug for reducing deaths and readmissions, especially in HFrEF patients.
Finally, Professor Eung-Joo Kim, who presented the topic of’Management of Concomitant Diseases in Heart Failure Patients’, in the DECLARE study, targets type 2 diabetes patients (eGFR 60mL/min/1.73m2 or more). /min/1.73m2, continuous reduction, death from end-stage renal failure or kidney disease) by 47%.In addition, the DAPA-HF study also showed a group of chronic heart failure patients with reduced left ventricular contractile function (eGFR 30 mL/min/ He explained that the target kidney complex variable (eGFR of at least 50% or more, death due to end-stage renal failure or kidney disease) also showed a trend of 29% decrease and showed the effect of treating heart failure regardless of the patient’s renal function.
Professor Kim said, “As kidney function deteriorates in heart failure patients, the risk of hospitalization and death from heart failure increases. Therefore, it is important to check kidney-related data in cardiology in terms of managing comorbidities.” He stressed that the rate of disease was reduced by 59% and the risk of dialysis patients was reduced by 69%.” “Chronic kidney disease has a greater effect on heart failure death than anemia and diabetes,” he said. “Diabetes itself has a negative effect on cardiovascular and heart failure, but as Foscigar has proven effective in patients with diabetes, it also prevents the progression of diabetes. It is meaningful because it can help with cardiovascular and kidney disease.”
Professor Choi Dong-ju, who held a meeting as a moderator, said, “Since heart failure is a disease with a low survival rate, the emergence of new treatment options is of great significance.” “If the results confirmed through Posiga’s clinical research are applied to the actual treatment environment, It is expected to make a great contribution to improving the survival rate of patients with heart failure.” “At the end of this month, a new guideline for heart failure treatment will be released at the American Heart Association,” he emphasized. “There are good medicines without setting steps 1, 2, and 3 as standard treatments, and there is a trend toward using them right away.” did.
Shim Il, managing director of AstraZeneca Korea (CVRM Division), said, “AstraZeneca proclaimed the vision’CaReMe (Cardiovascular, Renal, Metabolism)’ in 2018, which promotes an integrated approach to cardiovascular and renal endocrine diseases, and is suffering from multiple chronic diseases. We have been steadily striving to resolve the unmet needs of patients and ultimately improve treatment outcomes and reduce mortality,” he said. “As the first SGLT-2 inhibitor to acquire the indication for chronic heart failure treatment, we hope that it will contribute to the innovative change of the heart failure treatment paradigm. I hope” he added.
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