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ClinicalKey AI in action: Can I use an SGLT2 agent for management of HFpEF in a non-diabetic patient

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SGLT

Yes, you can use a sodium-glucose co-transporter-2 (SGLT2) inhibitor such as empagliflozin or dapagliflozin for the management of heart failure with preserved ejection fraction (HFpEF) in a non-diabetic patient. SGLT2 inhibitors like empagliflozin and dapagliflozin have been shown to reduce the risk of hospitalization for heart failure and improve symptoms and health-related quality of life in patients with HFpEF, regardless of their diabetes status.[1-3] The EMPEROR-Preserved trial demonstrated improved outcomes (21% reduction in cardiovascular death or HF hospitalization) in patients with HFpEF treated with empagliflozin, with benefits established in both diabetic and non-diabetic patients.[2][4] The DELIVER trial, which tested dapagliflozin, is expected to report its results soon, and it is anticipated that it may provide further evidence supporting the use of SGLT2 inhibitors in HFpEF.[3] The FDA has approved the use of empagliflozin for reducing the risk of cardiovascular death and HF hospitalization in patients with HFpEF.[2][5] Sotagliflozin, an SGLT1/2 inhibitor, has also been shown to reduce heart failure hospitalization in patients with HFpEF.[3][6]

  1. Heart Failure opens in new tab/window. McMurray, John J.V., Pfeffer, Marc A. In Goldman-Cecil Medicine (pp. 262).

  2. Chronic Heart Failure With Preserved Ejection Fraction, Management.  opens in new tab/window Elsevier ClinicalKey Clinical Overview

  3. Heart Failure with Preserved and Mildly Reduced Ejection Fraction.  opens in new tab/window Lam,, Carolyn S.P., Shah,, Sanjiv J., Solomon, Scott D. In Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine (pp. 1007).

  4. Empagliflozin in Heart Failure With a Preserved Ejection Fraction. opens in new tab/window Anker SD, Butler J, Filippatos G, et al. The New England Journal of Medicine. 2021;385(16):1451-1461. doi:10.1056/NEJMoa2107038.

  5. JARDIANCE. Label via DailyMed opens in new tab/window. Food and Drug Administration (DailyMed) FDA

  6. INPEFA. Label via DailyMed opens in new tab/window. Food and Drug Administration (DailyMed) FDA Answer generated on March 31, 2024 Note: User acknowledges that these materials are provided for use at no charge as part of Elsevier’s efforts to support healthcare providers and patients. The information contained within the website is intended as a supplement to, and not a substitute for, the knowledge, expertise, skill and judgment of healthcare professionals involved in patient care. The content within this page may not be re-used, modified or re-distributed without prior written permission.