As­traZeneca's di­a­betes drug Farx­i­ga cuts risk of CV death or wors­en­ing of heart fail­ure by 26% in land­mark study

About two weeks af­ter As­traZeneca’s $AZN un­veiled its di­a­betes treat­ment Farx­i­ga cut the risk of CV death or the wors­en­ing of heart fail­ure in pa­tients with heart dis­ease, in a land­mark tri­al — over the week­end the British drug­mak­er pre­sent­ed de­tailed da­ta at the Eu­ro­pean So­ci­ety of Car­di­ol­o­gy (ESC) Con­gress in Paris.

The re­sults em­anat­ed from the 4,744-pa­tient DA­PA-HF tri­al, which test­ed Farx­i­ga in pa­tients with re­duced ejec­tion frac­tion (HFrEF) — in which the heart mus­cle is not able to con­tract am­ply and, there­fore, ex­pels less oxy­gen-rich blood in­to the body — on stan­dard of care treat­ment, in­clud­ing those with and with­out type-II di­a­betes.

Farx­i­ga re­duced the com­pos­ite end­point of car­dio­vas­cu­lar (CV) death or wors­en­ing of heart fail­ure by 26% (p<0.0001) — in­clud­ing a re­duc­tion in each of the in­di­vid­ual com­po­nents of the end­point. Da­ta showed there was a 30% de­crease (p<0.0001) in the risk of ex­pe­ri­enc­ing a first episode of wors­en­ing heart fail­ure and an 18% cut (p=0.0294) in the risk of death from car­dio­vas­cu­lar caus­es.

John Mc­Mur­ray Uni­ver­si­ty of Glas­gow

Farx­i­ga “did all the things we would like any drug to do in heart fail­ure, which are to im­prove symp­toms, re­duce hos­pi­tal ad­mis­sions and in­crease sur­vival. Even bet­ter, Farx­i­ga was as ef­fec­tive in heart fail­ure pa­tients with­out di­a­betes as in those with di­a­betes,” John Mc­Mur­ray of the Uni­ver­si­ty of Glas­gow said in a state­ment on Sun­day.

Pa­tients with di­a­betes are of­ten af­flict­ed with oth­er co­mor­bidi­ties, such as obe­si­ty, CV dis­ease and kid­ney prob­lems. SGLT2 mak­ers have been vy­ing for a big­ger mar­ket share by dif­fer­en­ti­at­ing their drugs on the ba­sis of ther­a­peu­tic im­pact on re­nal im­pair­ment — but the ma­jor, most lu­cra­tive bat­tle­ground is the heart.

Farx­i­ga, akin to J&J’s $JNJ In­vokana and Eli Lil­ly’s $LLY Jar­diance, be­long to a class of di­a­betes drugs called sodi­um-glu­cose co-trans­porter 2 (SGLT2) in­hibitors, which work by curb­ing the ab­sorp­tion of glu­cose via the kid­neys so that sur­plus glu­cose is ex­cret­ed through uri­na­tion.

Last year, As­traZeneca pre­sent­ed mixed da­ta on Farx­i­ga from a large study in type-II di­a­betes pa­tients at risk for CV dis­ease or es­tab­lished CV dis­ease. In the DE­CLARE-TI­MI 58 tri­al, which in­clud­ed more than 17,000 pa­tients, Farx­i­ga met one of the main goals by con­fer­ring a sta­tis­ti­cal­ly-sig­nif­i­cant re­duc­tion in the com­pos­ite end­point of hos­pi­tal­iza­tion for heart fail­ure or CV death. But it failed to clear the co-pri­ma­ry end­point of re­duc­ing ma­jor ad­verse car­dio­vas­cu­lar events (MACE) ver­sus place­bo.

Farx­i­ga, which was ap­proved for use in type-II di­a­betes back in 2014 — whose sales un­der­whelmed an­a­lyst ex­pec­ta­tions in the sec­ond quar­ter — is al­so be­ing de­vel­oped for pa­tients with heart fail­ure in the DE­LIV­ER (HF­pEF) and DE­TER­MINE (HFrEF and HF­pEF) tri­als, in ad­di­tion to chron­ic kid­ney dis­ease in the DA­PA-CKD tri­al. Its ri­vals are test­ing their di­a­betes of­fer­ings in a range of heart and kid­ney tri­als as well.

Months ago, In­vokana da­ta in­di­cat­ed the drug con­ferred car­dio­vas­cu­lar (CV) ben­e­fit in pa­tients who do and do not have pre­ex­ist­ing CV dis­ease.

So­cial im­age: As­traZeneca, AP Im­ages

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