Innovative daily diabetes tablet to treat all Britons with heart failure gets NHS approval

Every Brit with heart failure will now be eligible for a breakthrough daily tablet that dramatically reduces symptoms and increases chances of survival.

The drug, called dapagliflozin, was previously only available to NHS patients with one of three types of heart failure, accounting for about half of the million people in the UK living with this incurable condition.

But the medicines watchdog, the National Institute for Health and Care Excellence (NICE), ruled last week that people with the other two types of heart failure should also be offered the drug for £244 a year, if his doctors think it will be of benefit.

Until now, many of these patients had relatively few treatment options and often faced a dismal prognosis. But dapagliflozin has been shown in trials to slow the decline in this group by about a fifth and reduce the risk of death by 18 percent.

Some patients taking the drug have been saved from needing a heart transplant, and experts are calling the drug’s extended approval by NICE “a turning point.”

“Until now, there has been a lack of treatments that reduce mortality for many patients with heart failure,” says John McMurray, professor of medical cardiology at the University of Glasgow, who led the trials.

Unlike a heart attack, which occurs when the blood supply to the heart is suddenly blocked, heart failure is a chronic condition in which the heart can no longer pump effectively because the muscle has weakened.

Symptoms, including debilitating fatigue and shortness of breath, can suddenly worsen, which is why heart failure causes about 86,000 emergency hospital admissions each year.

Triggers include heart attacks, high blood pressure, and viral infections, and about half of people with heart failure die within five years of diagnosis.

Although heart disease can occur at any age, it is more common in older people. The number of Britons affected has been rising steadily for decades due to a combination of an aging population and more people surviving heart attacks. An increasing number of patients living with diabetes and high blood pressure, which in turn increases the risk of heart failure, is also a factor.

There are three main types of heart failure. With the former, the heart’s main chamber is working 10 percent or more below its normal capacity. This is called heart failure with reduced ejection fraction, or HFrEF, a term that relates to the amount of blood ejected from the heart. The second type, heart failure with mildly reduced ejection fraction, or HFmrEF, means that the heart is functioning between one and 10 percent below its normal function.

The third, heart failure with preserved ejection fraction, or HFpEF, means that the heart is struggling to fill with blood properly.

In January 2021, health chiefs gave dapagliflozin the go-ahead for patients with reduced ejection fraction following trials that showed those taking the drug were one-third less likely to require urgent hospitalization.

The drug, called dapagliflozin, was previously only available to NHS patients with one of three types of heart failure, accounting for about half of the million people in the UK living with the incurable disease.

At the time of approval, Professor McMurray said: “We still can’t cure heart failure, but in some cases we can now put the condition into complete remission using a combination of drugs, including dapagliflozin, and save some patients who progress to pointing out that they need a heart transplant.

‘There are other drugs similar to dapagliflozin that we now know work as well, and more are coming in the future. We are undermining this disease.

The decision to approve the drug for the other two types of heart failure follows the results of an international trial that found that taking the pill for two years was equally beneficial for patients with mildly reduced or preserved ejection fraction disease.

The drug is in a class of drugs called sodium-glucose cotransporter-2 (SGLT2) inhibitors. They help diabetics by removing excess glucose from the body through urine.

Experts don’t fully understand why they have such a powerful effect on heart failure; one suggestion is that they reduce the amount of work the organ has to do to pump blood throughout the body.

Importantly, patients in the trials were found to experience few or no side effects.

Speaking about the drug’s approval, Nick Hartshorne-Evans, chief executive of heart failure charity Pumping Marvelous, said: “For a condition that is physically debilitating and severely limits a person’s quality of life, this is a critical step. in treating people living with the disease. .

“We hope that today’s decision can be a catalyst for prioritization of care for all types of heart failure in the UK, which is long overdue.”