Breakthrough daily diabetes tablet to treat all British heart failure sufferers secures NHS approval

All UK heart failure patients are now eligible for a groundbreaking daily tablet that dramatically reduces symptoms and improves survival.

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

But drug watchdog the National Institute for Health and Care Excellence (NICE) ruled last week that those with the other two types of heart failure should also be given the £244 a year medication, if their doctors believe it will be of benefit.

Until now, many of these patients had relatively few treatment options and often a poor prognosis. But studies have shown that dapagliflozin slows the decline in this group by about a fifth and reduces the risk of death by 18 percent.

Some patients who took the drug have been saved from a heart transplant. Experts call NICE’s expanded approval of the drug “a turning point.”

“Until now, treatments that reduce the mortality of many patients with heart failure have been lacking,” said John McMurray, a professor of medical cardiology at the University of Glasgow, who led the trials.

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

Symptoms, including debilitating fatigue and shortness of breath, can suddenly worsen. Therefore, heart failure causes approximately 86,000 emergency hospitalizations each year.

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

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

There are three main types of heart failure. In the first, the main chamber of the heart operates ten percent or more below its normal capacity. This is called heart failure with reduced ejection fraction, or HFrEF – a term that refers to the amount of blood that is pushed out of the heart. The second type — heart failure with mildly reduced ejection fraction, or HFmrEF — means the heart is operating anywhere from one to ten percent below its normal function.

The third – heart failure with preserved ejection fraction, or HFpEF – means the heart has trouble filling with blood properly.

In January 2021, health chiefs gave dapagliflozin the green light for patients with decreased ejection fraction after studies showed those taking the drug were a 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 – about half of the million people in the UK living with the incurable condition

At the time of the approval, Prof McMurray said: ‘We can’t yet cure heart failure, but in some cases we can now put the condition into full remission using a combination of drugs, including dapagliflozin, and save some patients who have come to the point of that they need a heart transplant.

“There are other drugs similar to dapagliflozin that we now know work as well, and more are on the way. We are chipping away at this disease.”

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

The drug is in a class of drugs called sodium-glucose co-transporter-2 (SGLT2) inhibitors. They help diabetics by flushing excess glucose from the body in the 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 around the body.

Importantly, patients in studies experienced few, if any, side effects.

Speaking of 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 an individual’s quality of life, this is a critical step in the treatment of people living with the disease. .

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