The type 2 diabetes drug Farxiga (dapagliflozin) may help prevent new cases of diabetes in people with chronic kidney disease or heart failure, according to a new study published in the journal The Lancet Diabetes & Endocrinology.
Farxiga, which belongs to a group of type 2 diabetes drugs called SGLT2 inhibitors, has been found since its initial approval in 2014 (for type 2 diabetes) to be effective in treating two other related health conditions — heart failure and chronic kidney disease. While many people with diabetes who also had either heart failure or chronic kidney disease were already taking this drug, new approvals from the U.S. Food and Drug Administration in 2020 (for heart failure) and 2021 (for chronic kidney disease) meant that even people without diabetes could take Farxiga. Later studies also showed that for people with heart failure, taking Farxiga may add years of life. But until now, there have been no major studies looking at whether taking Farxiga for either heart failure or chronic kidney disease reduces the risk for diabetes in people without the condition.
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For the latest study, researchers combined data from two different randomized controlled trials — this means that all participants were randomly assigned to take either Farxiga, another treatment, or a placebo (inactive pill). One trial included people with heart failure, and the other included people with chronic kidney disease. At the beginning of the study period, all 6,608 participants had no history of diagnosed diabetes and also had an A1C level (a measure of long-term blood glucose control) under 6.5%, indicating the absence of diabetes.
Farxiga linked to lower risk of diabetes diagnosis
During the study period, new cases of diabetes were established by two A1C measurements in a row of at least 6.5%, or by an official diabetes diagnosis outside the trial. Over a median follow-up period of 21.2 months, 126 out of 2,008 members of the placebo group (6.3%) developed type 2 diabetes, while 85 out of 1,995 members of the Farxiga group (4.3%) developed diabetes. More than 90% of people who developed type 2 diabetes during the study period had prediabetes — as shown by an A1C level of 5.7% to 6.4% — at the beginning of the study. The rate of developing type 2 diabetes was 3.9 per 100 person-years in the placebo group, and 2.6 per 100 person-years in the Farxiga group — meaning that the rate of developing diabetes was 33% lower in the Farxiga group.
The risk for developing diabetes was essentially the same regardless of which trial participants took part in — a strong sign that Farxiga predictably reduces the risk for type 2 diabetes in people with either heart failure or chronic kidney disease. There was also no clear evidence that the reduced risk for diabetes from taking Farxiga varied based on participants’ age, sex, starting A1C level, body-mass index (BMI, a measure of body weight that takes height into account), kidney function, systolic blood pressure (the “top number” measured during heartbeats), or use of prescription drugs to treat cardiovascular disease at the beginning of the study.
The researchers concluded that Farxiga may be a useful tool for diabetes prevention in people with heart failure or chronic kidney disease — especially those who already have prediabetes. This new evidence adds to the reasons why doctors may prescribe Farxiga for people with these heath conditions — on top of the established benefits for heart and kidney function.
Want to see more recent news about Farxiga? Read “Taking Farxiga for Heart Failure May Add Years of Life,” “Farxiga Approved for Chronic Kidney Disease,” and “Farxiga Approved for Form of Heart Failure, Regardless of Diabetes.”