Dapagliflozin is a SGLT2 inhibitor that was originally isolated from apple bark in 1835. It has been approved to treat heart failure in adults with and without type 2 diabetes in 2020. It was also approved in 2021 to reduce kidney disease progression and failure in adults with chronic kidney disease who are at risk of disease worsening. The 2021 ESC guidelines recommend Dapagliflozin for primary prevention of heart failure in patients with risk factors. It comes in 10mg tablets and has contraindications for type 1 diabetes, prior DKA, UTIs, low bone density, foot ulcers, and severe dehydration.
2. History
Phlorizin
In 1835, French chemists first isolated from the
bark of apple trees.
and in 1886, German physician and early
diabetes pioneer Joseph von Mering.
9. Approval Profile : Heart Failure :
Approved in May 2020 : for the treatment of heart
failure with reduced ejection fraction (HFrEF) in
adults with and without type 2 diabetes (T2D)
Approved in November 2020 : for the treatment of
symptomatic chronic heart failure with reduced
ejection fraction (HFrEF) in adults with and without
type-2 diabetes (T2D).
References :
Gianna Mellilo, FDA Approves Dapagliflozin to Treat Heart Failure, Breaking New Ground in SGLT2 Competition, AJMC , May 7 2020. Available Online <
FDA Approves Dapagliflozin to Treat Heart Failure, Breaking New Ground in SGLT2 Competition (ajmc.com)>
Available Online < Forxiga | European Medicines Agency (europa.eu)>, Sep 2021
10. Approval Profile : CKD :
Approved in April 2021: to reduce the risk of kidney
function decline, kidney failure, cardiovascular death and
hospitalization for heart failure in adults with chronic
kidney disease who are at risk of disease progression.
Approved in August 2021: for the treatment of chronic
kidney disease (CKD) in adults with and without type-2
diabetes (T2D).
References :
11. Status in most updated guidelines
References :
2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure, 27 8 2021 .
In Addition to treating HF , ESC Guidelines in 2021 for the treatment of acute and chronic HF
recommends Dapagliflozin for the primary prevention of HF in patients with risk factors for
its development