Empagliflozin is associated with reducing the risk of heart failure (HF) hospitalization among patients presenting with a broad range of ejection fractions, according to new data published in European Heart Journal.
Empagliflozin, an SGLT2 inhibitor, is sold by Boehringer Ingelheim and Eli Lilly and Company under the name Jardiance. Back in August 2021, the medication gained FDA approval as a treatment option for adult patients with HF with reduced ejection fraction (HFrEF). In September 2021, it received the FDA’s Breakthrough Therapy designation an investigational treatment for adults with HF with preserved ejection fraction (HFpEF).
The study’s authors examined data from nearly 10,000 adult HF patients from the previously completed EMPEROR-Reduced and EMPERIOR-Preserved trials. Approximately 50% of patients were given empagliflozin, and all other patients were treated with a placebo. Patients were grouped based on their ejection fraction — less than 25%, 25-34%, 35-44%, 45-54%, 55-64% and more than 65%.
Overall, the group found, a patient’s risk of cardiovascular mortality or hospitalization for HF decreased as their ejection fraction increased. The effect of treatment was especially apparent when looking at HF hospitalization rates, though that impact did lessen considerably when patients presented with an ejection fraction of more than 65%.
“Our finding of an attenuated effect of empagliflozin on heart failure outcomes in patients with an ejection fraction of 65% and greater requires further study,” wrote lead author Javed Butler, MD, with the department of medicine at the University of Mississippi School of Medicine in Jackson, and colleagues. “This subgroup represented by less than 10% of the entire patient population and the total number of events. As a result, our estimates for this subgroup are necessarily imprecise, and additional studies in this subgroup are needed to clarify the true effect of empagliflozin.”
Boehringer Ingelheim and Eli Lilly and Company did provide support for the original EMPEROR trials. Also, the study’s authors all reported working relationships with Boehringer Ingelheim.
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1. Javed Butler, Milton Packer, Gerasimos Filippatos, et al. Effect of empagliflozin in patients with heart failure across the spectrum of left ventricular ejection fraction. European Heart Journal, Volume 43, Issue 5, 1 February 2022, Pages 416–426.