Empagliflozin (Jardiance)

Indications

Congestive Heart Failure with Reduced Ejection Fraction (HFrEF) (see Congestive Heart Failure)

General Comments

  • FDA-Approved for This Indication in 2021

Clinical Efficacy

  • EMPEROR-Reduced Randomized, Double-Blinded, Placebo-Controlled Trial of Empaglifozin in Patients with Heart Failure (Class II-IV Heart Failure; Ejection Fraction ≤40%) (Circulation, 2021) [MEDLINE]: n = 3,730
    • Empagliflozin Decreased Risk of Death, Hospitalization for Heart Failure, or an Emergent/Urgent Heart Failure Visit Requiring Intravenous Treatment, as Compared to Placebo
    • Empagliflozin reduced the total number of heart failure hospitalizations that required intensive care
    • Empagliflozin-Treated Patients were 20-40% more likely to experience an improvement in New York Heart Association functional class and were 20% to 40% less likely to experience worsening of New York Heart Association functional class, with statistically significant effects that were apparent 28 days after randomization and maintained during long-term follow-up

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Pharmacology

Metabolism

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Administration

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Dose Adjustment

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Use in Pregnancy (see Pregnancy)

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Use in Lactation

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Adverse Effects

Other Adverse Effects

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References

  • Evaluation of the effect of sodium-glucose co-transporter 2 inhibition with empagliflozin on morbidity and mortality of patients with chronic heart failure and a reduced ejection fraction: rationale for and design of the EMPEROR-Reduced trial. Eur J Heart Fail. 2019 Oct;21(10):1270-1278. doi: 10.1002/ejhf.1536 [MEDLINE]
  • SGLT2 inhibitors in patients with heart failure with reduced ejection fraction: a meta-analysis of the EMPEROR-Reduced and DAPA-HF trials. Lancet. 2020 Sep 19;396(10254):819-829. doi: 10.1016/S0140-6736(20)31824-9 [MEDLINE]
  • Effect of Empagliflozin on the Clinical Stability of Patients With Heart Failure and a Reduced Ejection Fraction: The EMPEROR-Reduced Trial. Circulation. 2021 Jan 26;143(4):326-336. doi: 10.1161/CIRCULATIONAHA.120.051783 [MEDLINE]