ACC House Call: Where Will SGLT-2 Inhibitors Go Now?

If the opinion of Muthiah Vaduganathan, MD, MPH, on what data best defined cardiometabolic research in 2019—DAPA-HF and CREDENCE—is true, then what will define this year and next?

In a special edition House Call video conference interview with HCPLive®, Vaduganathan, a cardiologist at the Center for Advanced Heart Disease at Brigham and Women's Hospital, discussed SGLT2 trial data on the eve of the virtual kickoff for the American College of Cardiology (ACC) 2020 Scientific Sessions.

Vaduganathan projected the most significant trial of this year to be the Empagliflozin Outcome Trial in Patients with Chronic Heart Failure with Reduced Ejection Fraction (EMPEROR-Reduced) trial, in which Boehringer Ingelheim and Eli Lilly and Company are promoting the assessment the SGLT2 inhibitor’s safety and efficacy versus placebo on top of guideline-directed therapy in patients with heart failure with reduced ejection fraction (HFrEF).

Ventures into heart failure subtype care is the next step for the add-on drug class, Vaduganathan said, after showing benefits for cardiovascular risk reduction, glycemic control, and renal outcomes.

Though the trial data is slated for presentation at the European Society of Cardiology (ESC) 2020 Scientific Sessions later this year, that may change given the circumstances of the novel coronavirus (COVID-19) pandemic. Whenever it is made available, Vaduganathan anticipates it will influence understanding of the potential of high-risk heart failure treatment.

He also looked toward 2021, expecting more chronic kidney disease- and heart failure-related results for SGLT2 inhibitors. The drug class could become among the first marketed toward treating heart failure with preserved ejection fraction (HFpEF), pending empagliflozin and dapagliflozin findings.