Physician Views Preview: Will Jardiance result shake up how heart failure is treated?

Novartis' Entresto may have been approved by the FDA for harder-to-treat heart failure patients (those with preserved ejection fraction) back in February, but Eli Lilly was keen on Tuesday to tout Jardiance as the "first and only clinically proven therapy to improve outcomes for the full spectrum of heart failure patients regardless of ejection fraction," when announcing positive top-line data from the Phase III EMPEROR-Preserved study.

This is a less than subtle nod to the fact that Entresto, well established for the treatment of heart failure in patients with reduced ejection fraction, failed to meet its Phase III primary endpoint when evaluated in preserved ejection patients, but was approved in this setting as the FDA believes the totality of data suggests it is a valuable treatment option.

In light of the new Jardiance data, we are fielding a snap-poll to US cardiologists to provisionally ascertain how the future approval of this drug could impact the treatment landscape for heart failure. We are asking the following questions…

  • Approximately what percentage of heart failure patients with preserved ejection fraction (HFpEF) do you currently treat with Entresto (sacubitril/valsartan), following its approval in this indication in February?
  • Approximately what percentage of patients with HFpEF do you anticipate treating with Entresto in 12-18 months' time?
  • Based on your knowledge of the SGLT2 inhibitor class and EMPEROR-Preserved being the first Phase III study for HFpEF to meet its primary endpoint, how would you estimate long-term adoption trends for Jardiance (empagliflozin) in this indication, assuming approval is granted by the FDA?
  • Another SGLT2 inhibitor – Farxiga (dapagliflozin) – is already approved by the FDA to treat adults with heart failure with reduced ejection fraction (HFrEF). In this indication, do you tend to prioritise treatment with Farxiga or Entresto, use the two drugs broadly equally or in combination?
  • Given that Entresto narrowly missed its primary endpoint in the Phase III PARAGON-HF study for HFpEF – but was approved by the FDA on the basis that it might benefit some patients – could the presentation of impressive data for Jardiance at ESC in August potentially drive a paradigm shift in the priority adoption of Jardiance versus Entresto?

Survey results and analysis will be published later this week for FirstWord Pharma PLUS subscribers and can be purchased by non-FirstWord Pharma PLUS subscribers. To be notified when they become available, click here

To read more Physician Views Poll Results articles, click here.