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Real-world Dapagliflozin and Concomitant Medication Treatment Patterns in Portuguese Patients with Heart Failure with Reduced Ejection Fraction
Session:
Sessão de Posters 37 - Insuficiência cardíaca - Terapêutica farmacológica
Speaker:
Aurora Andrade
Congress:
CPC 2024
Topic:
D. Heart Failure
Theme:
10. Chronic Heart Failure
Subtheme:
10.6 Chronic Heart Failure - Clinical
Session Type:
Cartazes
FP Number:
---
Authors:
Aurora Andrade; Sara Gonçalves; Ana Batista; Ana Teresa Timóteo; Ana Oliveira Soares; Fátima Franco; Otília Simões; Marisa Pardal; Mário Almeida; Margarida Lopes; Filipa Bernardo; José Silva Cardoso
Abstract
<p style="text-align:justify"><strong>Introduction</strong></p> <p style="text-align:justify">Dapagliflozin is a sodium–glucose cotransporter 2 inhibitor approved in 2020 for treatment of heart failure with reduced ejection fraction (HFrEF) regardless of a diagnosis of diabetes and added in 2021 to the European Society of Cardiology guidelines as a Class I therapeutic for HFrEF.</p> <p style="text-align:justify"><strong>Objectives</strong></p> <div> <p style="text-align:justify">This study aimed to understand dapagliflozin and concomitant medication treatment patterns in Portuguese real-world setting.</p> <p style="text-align:justify"><strong>Methods</strong></p> <div> <p style="text-align:justify">EVOLUTION-HF is an observational, retrospective cohort study in 8 Portuguese sites with patients initiated on dapagliflozin for HFrEF (with or without a diagnosis of diabetes). Medical records were analysed, collecting information at the index date (date of dapagliflozin initiation), and at 6 and 12-month follow-ups.</p> <p style="text-align:justify"><strong>Results</strong></p> <div> <p style="text-align:justify">228 patients were included, mostly male (73%), mean 65 years old, 85% in NYHA II, with mean left ventricular ejection fraction (LVEF) of 29%, and mean eGFR of 77 mL/min/1.73m<sup>2</sup>.</p> <div> <p style="text-align:justify">At the index date, the most common cardiovascular scope medications included beta-blockers, aldosterone antagonists (MRA), and diuretics (92%/71%/71%, respectively). After dapagliflozin initiation, there was a higher level of prescription and/or up-titration of beta-blockers, MRAs, and angiotensin receptor-neprylisin inhibitors (ARNI), as well as down-titration/withdrawal of diuretics and angiotensin-converting enzyme (ACE) inhibitors. The EVOLUTION-HF study showed a tendency for higher use of ARNI and lower use of diuretics and ACE inhibitors at the index date compared with DAPA-HF. Regarding glucose-lowering drugs, there were 40 participants with this medication at the index date - changes in these medications, however, were not significant. At the end of follow-up, 5% of participants had discontinued dapagliflozin.</p> </div> </div> </div> </div> <p style="text-align:justify"><strong>Conclusions </strong></p> <div> <p style="text-align:justify">Treatment with dapagliflozin was maintained in 95% of the participants. The therapy at index date, changes in cardiovascular medication, and comparison with DAPA-HF therapy highlight both the focus of the participating sites and the potential role of dapagliflozin in optimizing Guideline-Directed Medical Therapy (GDMT).</p> </div>
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