The story from the start
These drugs began as a treatment for type-2 diabetes by excreting sugar through urine. What surprised researchers was the unexpected cardiovascular and renal benefit.
The pivotal trials
The DAPA-HF and EMPEROR-Reduced trials showed a marked drop in mortality and heart-failure hospitalizations among patients receiving dapagliflozin or empagliflozin, even without diabetes.
When to start?
- Patients with heart failure with reduced ejection fraction (HFrEF).
- Patients with heart failure with preserved ejection fraction (HFpEF) — per the latest guidelines.
- Patients with chronic kidney disease and elevated urinary albumin.
Pre-prescription cautions
Be wary of ketoacidosis and urinary or genital infections, especially in the first weeks of therapy. Renal function should also be reviewed regularly.
A drug that started for diabetes has ended up as a pillar of cardiology.
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About the author
د. تاح
محاضر متخصص في المجال الطبي، يقدم محتوى تعليمياً عالي الجودة.
