Related Experiment Video

Updated: Dec 5, 2025

Network Pharmacology Prediction and Metabolomics Validation of the Mechanism of Fructus Phyllanthi against Hyperlipidemia
11:06

Network Pharmacology Prediction and Metabolomics Validation of the Mechanism of Fructus Phyllanthi against Hyperlipidemia

Published on: April 7, 2023

2.5K

Effect of Dapagliflozin in DAPA-HF According to Background Glucose-Lowering Therapy

Kieran F Docherty1, Pardeep S Jhund1, Olof Bengtsson2

  • 1BHF Cardiovascular Research Centre, University of Glasgow, Glasgow, U.K.

Diabetes Care
|October 21, 2020
PubMed

Insights

Dapagliflozin benefits heart failure patients with type 2 diabetes, regardless of glucose-lowering therapy. The drug improved outcomes in the DAPA-HF trial, showing consistent efficacy across different treatment backgrounds.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Heart failure with reduced ejection fraction (HFrEF) is a significant cause of morbidity and mortality.
  • Type 2 diabetes (T2D) is a common comorbidity in HFrEF patients, often managed with glucose-lowering therapy (GLT).
  • The impact of background GLT on the efficacy of HFrEF treatments requires further elucidation.

Purpose of the Study:

  • To investigate whether the cardiovascular benefits of dapagliflozin in patients with HFrEF and T2D, as observed in the DAPA-HF trial, are influenced by their background glucose-lowering therapy.
  • To analyze treatment effects across different classes and combinations of GLTs.

Main Methods:

  • Analysis of data from the Dapagliflozin And Prevention of Adverse-Outcomes in Heart Failure (DAPA-HF) trial.
  • Subgroup analysis examining the primary outcome (composite of worsening heart failure or cardiovascular death) based on the use or non-use of GLT.
  • Further stratification by specific GLT classes and combinations.

Main Results:

  • In the 2,139 patients with T2D, dapagliflozin demonstrated a consistent effect on the primary outcome, irrespective of GLT use (HR 0.72 [95% CI 0.58-0.88]) versus no GLT use (HR 0.86 [0.60-1.23]).
  • The interaction P-value for GLT use was 0.39, indicating no significant difference in treatment effect based on GLT status.
  • Efficacy remained consistent across various GLT classes and combinations.

Conclusions:

  • Dapagliflozin provides significant benefits for patients with HFrEF and T2D, independent of their background glucose-lowering therapy.
  • The findings suggest that dapagliflozin can be effectively used in this patient population regardless of concurrent diabetes management strategies.
  • This supports the broad utility of dapagliflozin in managing HFrEF in patients with type 2 diabetes.
Abstract

More Related Videos

Author Spotlight: Network Pharmacology and Molecular Docking to Decipher the Action of Jiawei Shengjiang San Against Diabetic Kidney Disease08:15

Author Spotlight: Network Pharmacology and Molecular Docking to Decipher the Action of Jiawei Shengjiang San Against Diabetic Kidney Disease

Published on: May 10, 2024

818
Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test OGTT and Insulin Tolerance Test ITT08:13

Study of In Vivo Glucose Metabolism in High-fat Diet-fed Mice Using Oral Glucose Tolerance Test OGTT and Insulin Tolerance Test ITT

Published on: January 7, 2018

70.7K

Related Concept Videos

Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
419
Oral Hypoglycemic Agents: Biguanides and Glitazones01:26

Oral Hypoglycemic Agents: Biguanides and Glitazones

Biguanides, particularly metformin (Glucophage), are insulin sensitizers that enhance glucose uptake, thereby reducing insulin resistance. Unlike sulfonylureas, metformin doesn't prompt insulin secretion, which helps to curb hypoglycemia risk. Metformin is beneficial in treating conditions like polycystic ovary syndrome due to its insulin-resistance reduction capability. The drug's primary action involves curtailing hepatic gluconeogenesis, a significant contributor to high blood...
493
Oral Hypoglycemic Agents: α-Glucosidase Inhibitors01:19

Oral Hypoglycemic Agents: α-Glucosidase Inhibitors

α-glucosidase inhibitors, including acarbose (Precose), miglitol (Glyset), and voglibose (Voglib) (primarily available in Asia), are drugs that control blood sugar levels by delaying the digestion of starch and disaccharides. They achieve this by inhibiting α-glucosidase enzymes in the intestine, which slow the absorption of carbohydrates in the intestine, which in turn leads to a prolonged release of the glucoregulatory hormone GLP-1 from intestinal L-cells.
Acarbose and miglitol are...
430
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
459
Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
661
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
657