Dapagliflozin was built to lower blood sugar by making the kidneys dump glucose into urine. Researchers then tested it in patients with heart failure and a weak pumping chamber, including many who did not have diabetes at all.
In the DAPA-HF trial, John McMurray's team at the University of Glasgow randomly assigned about 4,700 heart failure patients to dapagliflozin or placebo. Over roughly 18 months, the drug cut the risk of cardiovascular death or worsening heart failure by about 26 percent, with the benefit holding regardless of diabetes status.
The finding reclassified an entire drug class built for diabetes into a heart failure treatment, and a sibling drug, empagliflozin, showed a similar effect the following year in the EMPEROR-Reduced trial. The trials ran large and relatively short, so how the benefit holds up over a decade, and how it works at the cellular level, is still being worked out.
Read the original study
A diabetes pill that forgot to check for diabetes.
Source
- McMurray, J. J. V., Solomon, S. D., Inzucchi, S. E., Køber, L., Kosiborod, M. N., Martinez, F. A., Ponikowski, P., Sabatine, M. S., Anand, I. S., Bělohlávek, J., Böhm, M., Chiang, C.-E., Chopra, V. K., de Boer, R. A., Desai, A. S., Diez, M., Drozdz, J., Dukát, A., Ge, J., . . . DAPA-HF Trial Committees and Investigators (2019). Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. New England Journal of Medicine, 381(21), 1995–2008. https://doi.org/10.1056/NEJMoa1911303