EASD: AstraZeneca piles on supporting evidence for Farxiga use in heart failure

AstraZeneca's Farxiga showed earlier this month that it can improve outcomes for non-diabetic heart failure patients. (AstraZeneca)

BARCELONA—Earlier this month, AstraZeneca turned heads with outcomes data showing its Farxiga (dapagliflozin) could improve heart failure outcomes for people both with and without diabetes. And now, the company is out with metabolic and safety data that further support Farxiga use in non-diabetic patients.

Thursday at the European Association for the Study of Diabetes (EASD) annual meeting, the British drugmaker presented results showing that Farxiga showed greater reductions in HbA1c, a common measure of blood glucose, among the 45% of DAPA-HF study patients with Type 2 diabetes.

In non-diabetic patients, it didn’t make a significant impact, “which is what you want to see,” Naeem Khan, AZ’s medical vice president of cardiovascular and metabolic disease, said.

The drug spurred weight loss in both groups, though diabetic patients saw larger reductions on average, measuring 1.6 kg versus 0.6 kg for patients without diabetes. And both groups saw a decrease in systolic blood pressure, too, Khan said.

Patients “across the board” also saw an increase in hematocrit, the volume percentage of red blood cells in blood. “That’s really interesting,” Khan noted, adding that “divergence from the metabolic effects to hematocrit and hemodynamic effects can be something this brings forward to see why dapagliflozin is working.”

And last but not least, data unveiled at EASD showed that side effects such as hypoglycemia and ketoacidosis only cropped up in the diabetes group; Farxiga didn’t increase their occurrence in those without diabetes.

“Things that people worry about with” use of Farxiga’s class of SGLT2 medicines—“they only happened in the diabetes group,” Khan said. “That should give some comfort” to doctors that treat non-diabetic heart failure patients.

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The new info follows the DAPA-HF presentation at this month’s European Society of Cardiology Congress in Paris, where AstraZeneca unveiled results showing that adding Farxiga to standard-of-care treatment could pare down the risk of cardiovascular death or hospitalization in heart failure patients by 26%—regardless of whether those patients had Type 2 diabetes.

Analysts predicted the data would boost Farxiga and its SGLT2 classmates, including Boehringer Ingelheim and Eli Lilly’s Jardiance—and potentially help Farxiga step on the toes of current heart failure offerings, including Novartis’ Entresto, too.

AstraZeneca certainly plans to try. “We are very much committed to continuing to have a strong presence in the primary care and endocrinologist space … and also really continuing the conversation where heart failure is treated in the cardiology space,” said Kiersten Combs, AZ’s U.S. vice president of cardiovascular and metabolic disease.

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And AstraZeneca’s “strong commercial presence” across the cardiovascular, metabolic and renal specialties “puts us in a good spot” to have that conversation, she added, pointing to AZ’s “strong legacy” in the cardiovascular space. That legacy “goes long and deep” into a number of different cardiology subspecialties, thanks to drugs such as cholesterol cash cow Crestor and clot-buster Brilinta.

“We will really, truly look to cover the spectrum—general cardiology as well as those who specialize in heart failure,” Combs said.