Physician Views: Another SGLT-2 impresses in heart failure

…can AstraZeneca's Farxiga press home any first-mover advantage?

Farxiga was approved by the FDA in May to reduce the risk of cardiovascular death and hospitalisation among adults suffering from heart failure with reduced ejection fraction (HFrEF), regardless of whether they have type II diabetes. This decision was supported by impressive data from the DAPA-HF study. Our previous snap-poll of US cardiologists in May suggests that physicians are enthused by the prospect of a new therapeutic option.

Now a second SGLT-2 inhibitor – Boehringer Ingelheim and Eli Lilly's Jardiance – has delivered very similar data in a large Phase III study, suggesting a drug-class effect. With cardiologists notoriously conservative when it comes to treatment practice, further evidence of efficacy could prove important in driving adoption. Our latest physician snap-poll investigates further…

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Q. In May, the FDA approved the SGLT-2 inhibitor Farxiga (dapagliflozin) to reduce the risk of cardiovascular (CV) death and hospitalisation for heart failure in adults suffering from heart failure with reduced ejection fraction (HFrEF), regardless of whether they have type II diabetes. Approval was based on data showing Farxiga reduced the risk of CV death or worsening of heart failure by 26% versus placebo.

Have you prescribed Farxiga for this use?

No

No – but I plan to

Yes

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Q. Data presented this weekend at the virtual European Society of Cardiology (ESC) meeting showed that a second SGLT-2 inhibitor – Jardiance (empagliflozin) – reduced the risk of CV death and hospitalisation for heart failure by 25% in HFrEF patients with and without diabetes. 

On a scale of 1 (no effect) to 5 (significant effect), do you think evidence of a drug-class effect will accelerate adoption of SGLT-2 inhibitors for the treatment of HFrEF patients with and without diabetes?

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Q. Approximately what percentage of HFrEF patients under your care do you anticipate treating with a SGLT-2 inhibitor 12 months from now?

__%

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Q. Closer analysis of respective Phase III clinical datasets show that Farxiga reduced the risk of CV death by 18% and the risk of worsening heart failure by 30%. By comparison, Jardiance reduced the risk of hospitalisation by 31% and the risk of CV death by 8%, but was evaluated in a sicker population with a higher percentage of patients with an ejection fraction of 30% of less.

Based on these data, do you think the clinical profile of one of the drugs will resonate more strongly with prescribers?

Yes – Farxiga

Yes – Jardiance

No – data are broadly comparable

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Q. Taking the clinical profiles of the two agents into account and using a scale of 1 (no role) to 5 (significant role), what role do you anticipate price/access will play in determining which drug is prescribed to patients?

Results and related analysis will shortly be published for FirstWord Pharma PLUS subscribers to read, with the opportunity for non-FirstWord Pharma PLUS subscribers to purchase these findings. To be notified when poll results and analysis become available, please click here

 

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