Empagliflozin: A Review in Symptomatic Chronic Heart Failure

Declarations

Funding The preparation of this review was not supported by any external funding.

Authorship and Conflict of interest James E. Frampton is a salaried employee6 of Adis International Ltd/Springer Nature, and declares no relevant conflicts of interest. All authors contributed to the review and are responsible for the article content.

Ethics approval, Consent to participate, Consent to publish, Availability of data and material, Code availability Not applicable.

Additional information about this Adis Drug Review can be found here.

Abstract

Empagliflozin (Jardiance®), a sodium-glucose cotransporter 2 inhibitor (SGLT2i) initially developed to treat type 2 diabetes mellitus (T2DM), has also been approved in the EU and USA for the treatment of all adults with symptomatic chronic heart failure (CHF), regardless of their left ventricular ejection fraction (LVEF). In pivotal phase III trials in ambulant patients with symptomatic CHF and mildly-reduced or preserved ejection fraction (EMPEROR-Preserved; LVEF > 40%) or those with symptomatic CHF and reduced ejection fraction (EMPEROR–Reduced; LVEF ≤ 40%), the addition of oral empagliflozin 10 mg/day to standard of care significantly reduced the risk of cardiovascular (CV) death or hospitalization for HF (HHF), as well as that of a number of other outcomes indicative of worsening HF, compared with placebo. The beneficial effect of empagliflozin on CV death/HHF was seen irrespective of the presence or absence of T2DM and regardless of background HF therapies. In addition, empagliflozin significantly improved health-related quality of life (HRQOL) and was generally well tolerated, with an adverse event profile that was generally consistent with that seen in patients with T2DM. Thus, empagliflozin is a valuable treatment option for ambulant patients with symptomatic CHF across a broad LVEF spectrum.

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