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Early Dapagliflozin Does Not Impact Diuretic Efficiency in Acute Heart Failure

Medically reviewed by Carmen Pope, BPharm. Last updated on May 9, 2024.

By Elana Gotkine HealthDay Reporter

THURSDAY, May 9, 2024 -- For patients with acute heart failure (AHF), early initiation of dapagliflozin does not affect diuretic efficiency, according to a study published in the April 9 issue of the Journal of the American College of Cardiology.

Zachary L. Cox, Pharm.D., from the Lipscomb University of Pharmacy in Nashville, Tennessee, and colleagues examined the diuretic efficacy and safety of early dapagliflozin initiation in AHF in a multicenter trial involving 240 patients. Within 24 hours of hospital presentation for hypervolemic AHF, patients were randomly assigned to dapagliflozin 10 mg once daily or structured usual care with protocolized diuretic titration until day 5 or hospital discharge. The primary outcome of diuretic efficiency was compared across treatment assignment.

The researchers observed no difference between the groups in diuretic efficiency. Reduced loop diuretic doses were seen in association with dapagliflozin (560 versus 800 mg), and there were fewer intravenous diuretic up-titrations to achieve weight loss equivalent to usual care. Diabetic, renal, and cardiovascular safety events were not increased with early dapagliflozin initiation. Improved median 24-hour natriuresis and urine output were seen in association with dapagliflozin, expediting hospital discharge during the study period.

"Dapagliflozin was not associated with a statistically significant reduction in weight-based diuretic efficiency but was associated with evidence for enhanced diuresis among patients with AHF," the authors write.

Several authors disclosed ties to pharmaceutical companies, including AstraZeneca, which manufactures dapagliflozin and funded the study.

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Posted May 2024

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