Publications
Stay up to date with our literature reviews which are curated by experts to feature the most important publications released each month. Explore our publications for access to concise summary slides for your own use.
Decline in Estimated Glomerular Filtration Rate After Dapagliflozin in Heart Failure With Mildly Reduced or Preserved Ejection Fraction: A Prespecified Secondary Analysis of the DELIVER Randomized Clinical Trial
JAMA Cardiol. 2023; online ahead of print DOI: 10.1001/jamacardio.2023.4664
An initial decline in eGFR often occurs after initiating a SGLT2i and has been observed in patients with diabetes, CKD and HF. A prespecified analysis of DELIVER evaluated the magnitude and frequency of an initial decline in eGFR (within the first month) and its association with CV and renal outcomes in 5,788 patients with HFpEF or HFmrEF.
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Efficacy of Finerenone in Patients with Type 2 Diabetes, Chronic Kidney Disease and Altered Markers of Liver Steatosis and Fibrosis: A FIDELITY Subgroup Analysis
Diabetes Obes Metab. 2023; online ahead of print DOI: 10.1111/dom.15305
This post hoc subgroup analysis from FIDELITY investigated the effect of finerenone on liver function, cardiovascular and kidney composite outcomes in patients with CKD and T2D, stratified by their risk of liver steatosis, inflammation and fibrosis.
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Mineralocorticoid Receptor Antagonist Use and the Effects of Empagliflozin on Clinical Outcomes in Patients Admitted for Acute Heart Failure: Findings from EMPULSE
Eur J Heart Fail. 2023; online ahead of print DOI: 10.1002/ejhf.2982
In the EMPULSE trial, empagliflozin produced greater clinical benefit than placebo in patients hospitalised for AHF. Although many patients with AHF are treated with MRAs, the interplay between empagliflozin and MRAs in AHF has not been explored. A post-hoc analysis of the EMPULSE trial aimed to evaluate the efficacy and safety of empagliflozin versus placebo according to MRA use at baseline.
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Short-Term Costs in Patients with Chronic Kidney Disease Treated with Dapagliflozin: a Retrospective Cohort Study
Expert Rev Pharmacoecon Outcomes Res. 2023; online ahead of print DOI: 10.1080/14737167.2023.2237679
Analyses have found that dapagliflozin is cost-effective in the long term in patients with non-diabetic CKD and in patients with CKD with or without T2D. The slowing of eGFR decline and the early reduction in HF hospitalisation seen with dapagliflozin suggest that there is potential for short-term cost benefits in patients with CKD; however, there is a lack of real-world evidence. This retrospective observational cohort study described the impact of dapagliflozin on short-term medical costs in propensity matched patients with stage 3 CKD.
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Racial Differences in Quality of Life in Patients With Heart Failure Treated With Sodium-Glucose Cotransporter 2 Inhibitors: A Patient-Level Meta-Analysis of the CHIEF-HF, DEFINE-HF, and PRESERVED-HF Trials
Circulation. 2023; DOI: 10.1161/CIRCULATIONAHA.122.063263
Health status outcomes, including symptoms, function and QoL are worse for Black compared with White patients with HF. However, it is not known whether the health status benefits of SGLT2i are similar across races. This patient-level meta-analysis used data from three US-based trials that enrolled a substantial proportion of Black patients (DEFINE-HF, PRESERVED-HF and CHIEF-HF) to assess the effects of SGLT2is versus placebo on health status for Black compared with White patients with HF.
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Effect of Canagliflozin on Heart Failure Hospitalization in Diabetes According to Baseline Heart Failure Risk
JACC Heart Fail. 2023. DOI: 10.1016/j.jchf.2023.03.025
In the CANVAS programme, canagliflozin reduced the risk of HF hospitalisation among individuals with T2D. This post hoc analysis evaluated heterogeneity in the treatment effects of canagliflozin on HF hospitalisation according to baseline HF risk as assessed by two diabetes-specific HF risk scores: WATCH-DM (for participants without prevalent HF) and TRS-HFDM (all participants).
Benefits and Harms of Drug Treatment for Type 2 Diabetes: Systematic Review and Network Meta-Analysis of Randomised Controlled Trials
BMJ 2023;381:e074068 DOI 10.1136/bmj-2022-074068
Keeping abreast of the rising volume of randomized trials in adults with type 2 diabetes presents a formidable task. Recent randomized trials have shown cardiovascular and kidney advantages with finerenone, an innovative non-steroidal mineralocorticoid receptor antagonist, and weight loss with tirzepatide, a dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 (GLP-1) receptor agonist.
Cardiac and Kidney Benefits of Empagliflozin in Heart Failure Across the Spectrum of Kidney Function: Insights From the EMPEROR-Preserved Trial
European Journal of Heart Failure 2023 DOI 10.1002/ejhf.2857
In the EMPEROR-Preserved trial, empagliflozin was found to improve the clinical outcomes of patients with heart failure and preserved ejection fraction (HFpEF). This pre-specified analysis sought to explore the effect of empagliflozin on cardiovascular (CV) and kidney outcomes across different levels of kidney function.
Advances in the Management of Heart Failure with Reduced Ejection Fraction; The Role of SGLT2is, ARNI, Myotropes, Vericiguat, and Anti-inflammatory Agents: A Mini-review
Curr Pharm Des. 2023; online ahead of print DOI: 10.2174/1381612829666230316142450
This mini-review summarises recent data on new treatments for HFrEF. The article highlights that SGLT2i have revolutionised the management of HFrEF via significant reductions in CV mortality and HF hospitalisations. The role of sacubitril/valsartan as a potential replacement for ACEis and ARBS is discussed. New data on promising disease-modifying therapies are highlighted including vericiguat, which restores the impaired cyclic guanosine monophosphate pathway, and omecamtiv mecarbil, which stimulates cardiac myosin without marked arrhythmogenesis. The lack of success in developing anti-inflammatory agents for HFrEF, despite inflammasome activity being implicated in HFrEF pathophysiology, is discussed.
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Effects of Dapagliflozin on Hospitalisations in People with Type 2 Diabetes: Post-hoc Analyses of the DECLARE-TIMI 58 Trial
Lancet Diabetes Endocrinol. 2023;11:233–241 DOI: 10.1016/S2213-8587(23)00009-8
In patients with T2D at high risk of CV or kidney disease, SGLT2is consistently reduce the risk of HF hospitalisations. Less is known about their effects on hospitalisation from any cause, especially in patients with T2D without ASCVD, which includes most of the global population with T2D. Post hoc analyses of DECLARE-TIMI 58 assessed the effect of dapagliflozin on the risks of hospitalisations for any cause and for specific causes in patients with T2D with and without ASCVD.