'Innovative' heart failure treatment recommended by NICE

NICE has recommended dapagliflozin as an option for the treatment of symptomatic chronic heart failure with reduced ejection fraction in adults, concluding that the drug is 'innovative' and 'a stepchange' in the treatment of this condition.

Dapagliflozin is approved by NICE as an add-on to optimised standard care, defined as ACE inhibitors or angiotensin II antagonists, with beta blockers, and, if tolerated, aldosterone antagonists; or sacubitril/valsartan, with beta blockers, and, if tolerated, aldosterone antagonists.

NICE recommends that treatment is started on the advice of a heart failure specialist, and says that monitoring should be done by the most appropriate healthcare professional.

NICE's recommendation is based on the results of the DAPA-HF trial, published in 2019.

Survival benefit

Commenting on NICE's draft decision in December, Professor John McMurray from the Institute of Cardiovascular and Medical Sciences at the University of Glasgow, said: 'This is great news for people with heart failure with reduced ejection fraction, as they will now be able to receive a completely novel treatment for their condition, which, when added to existing therapy, improves symptoms, reduces the need for hospital admission and increases survival. Dapagliflozin can make a huge difference for those suffering from this life-restricting and life-threatening condition.'

Of the almost one million people living with heart failure in the UK, approximately 250,000 patients in England and Wales could be eligible for dapagliflozin treatment.