Diabetes drug offers significant protection against heart failure: Study

A diabetes drug sold here could lead to a better quality of life for the 450,000 diabetics in Singapore, after it was found to significantly protect against heart failure.

A large clinical trial of AstraZeneca’s Forxiga, one of three SGLT2 (sodium glucose cotransporter) inhibitors on the market, found that it reduced hospitalisation for heart failure among diabetics by 17 per cent.

The results of the study of more than 17,000 diabetics in 33 countries over 4.2 years were released last Saturday, the first day of the American Heart Association’s three-day Scientific meeting in Chicago.

Asians with diabetes are at far higher risk of getting heart failure than Caucasians, and the disease often results in their being hospitalised multiple times.

Dr Peter Yan, a cardiologist in private practice, told The Straits Times that Asians with diabetes have triple the risk of heart failure compared with Caucasians. Six in 10 of his patients have some form of diabetes.

The study found that Forxiga – also known as Dapagliflozin – was able to help both diabetics who already suffer from heart failure and those who do not.

Asians with diabetes are at far higher risk of getting heart failure than Caucasians, and the disease often results in their being hospitalised multiple times.

For those with heart failure, it reduced hospitalisation by 21 per cent.

In general, about 70 per cent of diabetics get heart failure within five years of being diagnosed with diabetes, although some may not show any symptoms.

For diabetics without heart failure, Forxiga reduced the incidence of hospitalisation for the condition by 16 per cent.

Forxiga, an oral medication used to control blood sugar levels, is subsidised under the Health Ministry’s Medication Assistance Fund.

Patients may also use Medisave under the outpatient chronic disease management programme to pay for the drug.

One Dapagliflozin tablet costs $1.36 before the subsidy, with the subsidy shaving off half to three-quarters of the cost.

Dr Stanley Liew, an endocrinologist at Raffles Hospital, said the trial showed the drug “resulted in lower rates of hospitalisation for heart failure. So we should consider the use of this drug in those without heart failure to prevent the disease”.

He said the drug “helps to address an important medical need among a diverse group of patients with Type 2 diabetes by reducing hospitalisation or cardiovascular death, with a safety profile supportive of broad use”.

Professor Tan Huay Cheem, director of the National University Heart Centre Singapore, welcomed the results.

He noted that since heart failure is more common among diabetics than heart attack, anything that can prevent the condition is good.

He said diabetics are 1.5 times more likely to die from heart failure than a non-diabetic.

Prof Tan added that compared with people with no diabetes, diabetic men are 2.4 times more likely to get heart failure while diabetic women face five times the risk.

Dr Yan said both endocrinologists and cardiologists at the meeting agreed that the Forxiga drug can help the majority of diabetics.

He said: “The class of SGLT2 inhibitors is very powerful in reducing heart failure hospitalisation and appears to be independent of the glucose control.”

The drug was also able to reduce renal disease by 24 per cent. But it was not able to show better prevention of cardiovascular death, stroke or heart attacks in diabetics.

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