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Can heart failure be treated with diabetes drug?

December 3, 2020

Participants of a trial with heart failure treated with Empagliflozin, a drug used in diabetes, improved their condition
Participants treated with Empagliflozin showed 16.6% improvement in the left ventricle ejection and the overall heart condition

Conditions like high blood pressure, diabetes, atherosclerosis, obesity, and heart valve insufficiency can lead to heart failure. If a person suffers from heart failure, this means that their heart is not able to deliver blood to every part of the body when needed; hence signs like lower limbs swelling, tiredness, and shortness of breath, especially during exercise or even resting, can be present. In worse cases, there can be an accumulation of fluids in the lungs and lower limbs. When the left ventricle of the heart cannot pump the blood effectively, blood cannot circulate through the whole body, resulting in left ventricle dysfunction, which is found in half of the patients with heart failure; this translates as Heart Failure with Reduced Ejection Fraction (HFrEF). Improving lifestyles, adjusting the number of liquids consumed or salt added to the food and medication, and healthy habits are part of the treatments used to treat heart failure. Also, reducing alcohol and smoking habits are an essential part of the treatment. As part of a clinical trial where HFrEF was studied in non-diabetic individuals, a drug called Empagliflozin used to treat type 2 diabetes was tested. This investigation was called EMPATROPISM and was developed by researchers from the Icahn School of Medicine at Mount Sinai. The first results from this trial appeared in the Journal of the American College of Cardiology and later on presented on November 13 at the American Heart Association (AHA) Scientific Sessions. During the study, 84 participants were selected between 18-85 years of age and later separated into two groups. One of them received a daily dose of 10 milligrams of the drug Empagliflozin, while the rest took a placebo. Before the trial, participants were subjected to a cardiopulmonary exercise test to record their oxygen levels, as well as a cardiac MRI, and a 6-minute walk test among a full medical history. These tests were performed again after six months in which they were taking either the drug or the placebo. As a result, 80% of the participants receiving the medication showed 16.6% improvement in the left ventricle ejection fraction and an improvement in congestion and reduction in thickness and heart size, which translates as a significant improvement in the heart failure condition. Even if Empagliflozin is a drug used to treat diabetes, during the trial, no hypoglycemia wasn’t found, or any other adverse effect of using this drug on a non-diabetic person; on the other hand, quality of life and response to exercise improved soon after the beginning of the treatment. Participants treated with placebo didn’t show any benefit, and in some cases, the ejection fraction was reduced and heart size increased, leading to worsening heart failure. The investigators explained that the improvement of the condition was caused by avoiding heart’s modeling as a compensation of heart failure, especially when other health pathologies are present in the same individual. A previous double-blind study, named EMPEROR-Reduced, showed similar results; in this trial, 3730 participants with HFrEF were treated with a daily dose of 10 mg of Empagliflozin or a placebo, together with complementary therapy. Similar results to the EMPATROPISM trial were shown; participants taking the drug had shown improvement of their cardiovascular condition whether they were diabetic or not. Carlos Santos-Gallego, a postdoctoral fellow at the Ichan School of Medicine and one of the authors of EMPATROPISM, says, “Our clinical trial’s promising results show this diabetes drug can ameliorate lives of heart failure patients with reduced ejection fraction, enhance their exercise capacity, and improve their quality of life with little to no side effects.” He expects these findings to lead to the Food and Drug Administration (FDA) to approve the use of the drug Empagliflozin to treat heart failure in the next years.

References: https://www.medicalnewstoday.com/articles/diabetes-drug-shows-promise-in-treating-and-reversing-heart-failure

Can heart failure be treated with diabetes drug?

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