While heart failure with reduced pump function has been treated with medication for many years, there has been no specific therapy for HFpEF patients: doctors only treated symptoms and concomitant diseases such as high blood pressure and diabetes.
In a large-scale clinical study with almost 6000 participants, researchers have now provided evidence that the active ingredient empagliflozin improves the prognosis for HFpEF patients. The active ingredient is currently approved in Europe for the treatment of type 2 diabetes mellitus. Heart failure patients with reduced pumping capacity are already being treated with it. The EMPEROR-Preserved study was presented at the congress of the European Society of Cardiology (ESC) at the end of August.
Around 60 million people worldwide suffer from cardiac insufficiency, around half of them from HFpEF. HFpEF is the most common type of heart failure in the elderly. The heart is still pumping vigorously, but the left ventricle is stiff and does not fill sufficiently with oxygen-rich blood.
Safe drug with mild side effects
Because the heart can no longer pump enough blood through the body, heart failure patients often suffer from temporary exhaustion during exercise and shortness of breath. If the disease progresses, they become out of breath with slight movement or even at rest. Water retention, for example in the ankles, are also signs of a weak heart.
"For the first time, we can offer people suffering from cardiac insufficiency with preserved pumping function a drug that improves their prognosis and also their well-being - and that with a very good safety profile," says the head of the international study, Professor Stefan Anker from the Charité - University Medicine Berlin. “The side effects are mild and can be treated well medically.” Professor Anker is a Principal Investigator at the DZHK.
People with diabetes who develop HFpEF could already receive the drug as part of its approval. The manufacturer is also planning to apply for a license extension for the treatment of HFpEF.
Anker SD et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med (2021), doi: 10.1056/NEJMoa2107038.