QUALITY OF LIFE IN HEART FAILURE PATIENTS RECEIVING SODIUM GLUCOSE -2 (SGLT2) INHIBITORS: A LITERATURE REVIEW

Kinanti Alfathia; Neily Zakiyah; Triwedya Indra Dewi; Irma Melyani Puspitasari

doi:10.34011/jmp2k.v35i3.3059

Authors

Kinanti Alfathia Universitas Padjadjaran, Sumedang, Indonesia
Neily Zakiyah Universitas Padjadjaran, Sumedang, Indonesia
Triwedya Indra Dewi Universitas Padjadjaran, Bandung, Indonesia
Irma Melyani Puspitasari Universitas Padjadjaran, Sumedang, Indonesia

DOI:

https://doi.org/10.34011/jmp2k.v35i3.3059

Keywords:

dapagliflozin, empagliflozin, gagal jantung, kualitas hidup, SGLT2 inhibitor

Abstract

Gagal jantung merupakan kondisi klinis progresif yang berdampak signifikan terhadap kualitas hidup pasien. Penghambat Natrium Glukosa Co-transporter-2 (SGLT2), yang awalnya dikembangkan untuk terapi diabetes melitus tipe 2, telah menunjukkan manfaat kardiovaskular. Studi ini bertujuan mengevaluasi dampak penggunaan penghambat SGLT2, terhadap kualitas hidup pasien gagal jantung melalui tinjauan sistematis literatur. Penelusuran dilakukan di database PubMed dan EBSCOhost untuk menemukan uji klinis terkontrol secara acak yang melaporkan perubahan kualitas hidup menggunakan instrumen valid seperti Kansas City Cardiomyopathy Questionnaire (KCCQ) dan EuroQol 5-Dimension (EQ-5D). Dari 398 artikel yang diidentifikasi, sebanyak 20 studi memenuhi kriteria inklusi dan dianalisis secara kualitatif. Hasil menunjukkan bahwa terapi penghambat SGLT2 secara konsisten meningkatkan skor KCCQ dan EQ-5D secara bermakna dibandingkan plasebo, mencerminkan perbaikan pada aspek fisik, gejala klinis, dan kesejahteraan emosional. Efektivitas ini tercatat konsisten pada berbagai subpopulasi, terlepas dari status diabetes dan tipe fraksi ejeksi dan mendukung peran SGLT2 inhibitor sebagai terapi komprehensif dalam meningkatkan kualitas hidup pasien gagal jantung.

References

G. Savarese, P. M. Becher, L. H. Lund, P. Seferovic, G. M. C. Rosano, and A. J. S. Coats, “Global burden of heart failure: a comprehensive and updated review of epidemiology,” Dec. 01, 2022, Oxford University Press. doi: 10.1093/cvr/cvac013.

V. Atella et al., “Trends in age ‐ related disease burden and healthcare utilization,” no. May 2018, 2019, doi: 10.1111/acel.12861.

B. Shahim, C. J. Kapelios, G. Savarese, and L. H. Lund, “Global Public Health Burden of Heart Failure: An Updated Review,” Card. Fail. Rev., vol. 9, Jul. 2023, doi: 10.15420/cfr.2023.05.

P. A. Heidenreich et al., “2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines,” Circulation, vol. 145, no. 18, pp. E876–E894, 2022, doi: 10.1161/CIR.0000000000001062.

T. A. McDonagh et al., “2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure,” Eur. Heart J., vol. 42, no. 36, pp. 3599–3726, 2021, doi: 10.1093/eurheartj/ehab368.

N. Kupper, C. Bonhof, B. Westerhuis, J. Widdershoven, and J. Denollet, “Determinants of Dyspnea in Chronic Heart Failure,” J. Card. Fail., vol. 22, no. 3, pp. 201–209, 2016, doi: 10.1016/j.cardfail.2015.09.016.

J. Lu et al., “The Prevalence of Activities of Daily Living Impairment in Patients With Heart Failure: A Systematic Review and Meta-Analysis,” Front. Cardiovasc. Med., vol. 9, no. July, pp. 1–10, 2022, doi: 10.3389/fcvm.2022.952926.

S. Boczor, A. Daubmann, M. Eisele, E. Blozik, and M. Scherer, “Quality of life assessment in patients with heart failure: Validity of the German version of the generic EQ-5D-5LTM,” BMC Public Health, vol. 19, no. 1, pp. 1–11, 2019, doi: 10.1186/s12889-019-7623-2.

R. Rubio et al., “Quality of life and disease experience in patients with heart failure with reduced ejection fraction in Spain: A mixed-methods study,” BMJ Open, vol. 11, no. 12, pp. 1–9, 2021, doi: 10.1136/bmjopen-2021-053216.

K. E. Freedland, M. W. Rich, and R. M. Carney, “Improving Quality of Life in Heart Failure,” Curr. Cardiol. Rep., vol. 23, no. 11, p. 159, 2021, doi: 10.1007/s11886-021-01588-y.

C. H. Jung, J. E. Jang, and J. Y. Park, “A Novel therapeutic agent for type 2 diabetes mellitus: SGLT2 inhibitor,” Diabetes Metab. J., vol. 38, no. 4, pp. 261–273, 2014, doi: 10.4093/dmj.2014.38.4.261.

J. I. Fonseca-Correa and R. Correa-Rotter, “Sodium-Glucose Cotransporter 2 Inhibitors Mechanisms of Action: A Review,” Front. Med., vol. 8, no. December, pp. 1–7, 2021, doi: 10.3389/fmed.2021.777861.

A. M. Abdelrahman, A. S. Awad, and E. M. Abdel-Rahman, “Sodium-Glucose Co-Transporter 2 Inhibitors: Mechanism of Action and Efficacy in Non-Diabetic Kidney Disease from Bench to Bed-Side,” J. Clin. Med., vol. 13, no. 4, 2024, doi: 10.3390/jcm13040956.

D. Tomasoni et al., “Sodium-glucose co-transporter 2 inhibitors as an early, first-line therapy in patients with heart failure and reduced ejection fraction.,” Eur. J. Heart Fail., vol. 24, no. 3, pp. 431–441, Mar. 2022, doi: 10.1002/ejhf.2397.

S. J. Greene, J. Butler, and M. N. Kosiborod, “Chapter 3: Clinical Trials of Sodium-Glucose Co-Transporter-2 Inhibitors for Treatment of Heart Failure,” Am. J. Med., vol. 137, no. 2, pp. S25–S34, 2024, doi: 10.1016/j.amjmed.2023.04.019.

G. Stein, Paul D., Fowler, Sarah E., “Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction,” N. Engl. J. Med., vol. 355, pp. 11–20, 2006, doi: 10.1056/NEJMoa1911303.

K. M. Talha, S. D. Anker, and J. Butler, “SGLT-2 Inhibitors in Heart Failure: A Review of Current Evidence,” Int. J. Hear. Fail., vol. 5, no. 2, pp. 82–90, 2023, doi: 10.36628/ijhf.2022.0030.

S. D. Solomon et al., “Dapagliflozin in Heart Failure with Mildly Reduced or Preserved Ejection Fraction,” N. Engl. J. Med., vol. 387, no. 12, pp. 1089–1098, 2022, doi: 10.1056/nejmoa2206286.

M. Vaduganathan et al., “SGLT2 inhibitors in patients with heart failure: a comprehensive meta-analysis of five randomised controlled trials,” Lancet, vol. 400, no. 10354, pp. 757–767, Sep. 2022, doi: 10.1016/S0140-6736(22)01429-5.

M. Packer et al., “Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure,” N. Engl. J. Med., vol. 383, no. 15, pp. 1413–1424, 2020, doi: 10.1056/nejmoa2022190.

S. D. Anker et al., “Empagliflozin in Heart Failure with a Preserved Ejection Fraction,” N. Engl. J. Med., vol. 385, no. 16, pp. 1451–1461, 2021, doi: 10.1056/nejmoa2107038.

C. Oriecuia et al., “Sodium glucose co-transporter 2 inhibitors and quality of life in patients with heart failure: a comprehensive systematic review and meta-analysis of randomized controlled trials,” Eur. Hear. J. - Cardiovasc. Pharmacother., vol. 10, no. 2, pp. 147–157, 2024, doi: 10.1093/ehjcvp/pvad088.

J. A. Spertus, P. G. Jones, A. T. Sandhu, and S. V. Arnold, “Interpreting the Kansas City Cardiomyopathy Questionnaire in Clinical Trials and Clinical Care: JACC State-of-the-Art Review,” J. Am. Coll. Cardiol., vol. 76, no. 20, pp. 2379–2390, 2020, doi: 10.1016/j.jacc.2020.09.542.

I. E. Sukosd, S. A. Pescariu, C. Faur, A. I. Danila, C. Prodan-Barbulescu, and O. Fira-Mladinescu, “Utility of Kansas City Cardiomyopathy Questionnaire (KCCQ) in Assessing Quality of Life among Patients with Heart Failure Undergoing Exercise Training Rehabilitation: A Systematic Review,” Diseases, vol. 12, no. 4, 2024, doi: 10.3390/diseases12040064.

Y. S. Feng, T. Kohlmann, M. F. Janssen, and I. Buchholz, “Psychometric properties of the EQ-5D-5L: a systematic review of the literature,” Qual. Life Res., vol. 30, no. 3, pp. 647–673, 2021, doi: 10.1007/s11136-020-02688-y.

M. Yang et al., “Dapagliflozin and quality of life measured using the EuroQol 5-dimension questionnaire in patients with heart failure with reduced and mildly reduced/preserved ejection fraction,” Eur. J. Heart Fail., vol. 26, no. 7, pp. 1524–1538, 2024, doi: 10.1002/ejhf.3263.

P. C. Schulze et al., “Effects of Early Empagliflozin Initiation on Diuresis and Kidney Function in Patients With Acute Decompensated Heart Failure (EMPAG-HF),” Circulation, vol. 146, no. 4, pp. 289–298, 2022, doi: 10.1161/CIRCULATIONAHA.122.059038.

S. Carbone et al., “The effects of canagliflozin compared to sitagliptin on cardiorespiratory fitness in type 2 diabetes mellitus and heart failure with reduced ejection fraction: The CANA-HF study,” Diabetes. Metab. Res. Rev., vol. 36, no. 8, p. e3335, 2020, doi: 10.1002/dmrr.3335.

S. F. F. Gilani, S. Ali, K. Farhat, M. Noor, M. B. Siddiqui, and F. Waqar, “Early initiation of Dapagliflozin and its effect on health related quality of life in acute heart failure: a randomised controlled trial,” J. Pak. Med. Assoc., vol. 74, no. 4, pp. 621–625, 2024, doi: 10.47391/JPMA.9813.

T. Kondo et al., “Dapagliflozin and Days of Full Health Lost in the DAPA-HF Trial,” J. Am. Coll. Cardiol., vol. 83, no. 20, pp. 1973–1986, 2024, doi: 10.1016/j.jacc.2024.03.385.

M. E. Nassif et al., “Dapagliflozin Improves Heart Failure Symptoms and Physical Limitations Across the Full Range of Ejection Fraction: Pooled Patient-Level Analysis from DEFINE-HF and PRESERVED-HF Trials,” Circ. Hear. Fail., vol. 16, no. 7, p. E009837, 2023, doi: 10.1161/CIRCHEARTFAILURE.122.009837.

A. S. Bhatt et al., “Effect of dapagliflozin on health status and quality of life across the spectrum of ejection fraction: Participant-level pooled analysis from the DAPA-HF and DELIVER trials.,” Eur. J. Heart Fail., vol. 25, no. 7, pp. 981–988, Jul. 2023, doi: 10.1002/ejhf.2909.

K. F. Docherty et al., “Efficacy of Dapagliflozin in Black Versus White Patients With Heart Failure and Reduced Ejection Fraction,” JACC Hear. Fail., vol. 10, no. 1, pp. 52–64, 2022, doi: 10.1016/j.jchf.2021.08.006.

J. H. Butt et al., “Efficacy and safety of dapagliflozin according to frailty in patients with heart failure: A prespecified analysis of the DELIVER trial,” Circulation, vol. 146, no. 16, pp. 1210–1224, 2022, doi: 10.1161/CIRCULATIONAHA.122.061754.

P. Dewan et al., “Effects of dapagliflozin in heart failure with reduced ejection fraction and chronic obstructive pulmonary disease: an analysis of DAPA-HF,” Eur. J. Heart Fail., vol. 23, no. 4, pp. 632–643, 2021, doi: 10.1002/ejhf.2083.

M. E. Nassif et al., “The SGLT2 inhibitor dapagliflozin in heart failure with preserved ejection fraction: a multicenter randomized trial,” Nat. Med., vol. 27, no. 11, pp. 1954–1960, 2021, doi: 10.1038/s41591-021-01536-x.

M. N. Kosiborod et al., “Effects of dapagliflozin on symptoms, function, and quality of life in patients with Heart Failure and reduced ejection fraction: Results from the DAPA-HF trial,” Circulation, vol. 141, no. 2, pp. 90–99, 2020, doi: 10.1161/CIRCULATIONAHA.119.044138.

J. Tromp et al., “Treatment effects of empagliflozin in hospitalized heart failure patients across the range of left ventricular ejection fraction - Results from the EMPULSE trial,” Eur. J. Heart Fail., vol. 26, no. 4, pp. 963–970, 2024, doi: 10.1002/ejhf.3218.

M. J. Hundertmark et al., “Assessment of Cardiac Energy Metabolism, Function, and Physiology in Patients With Heart Failure Taking Empagliflozin: The Randomized, Controlled EMPA-VISION Trial,” Circulation, vol. 147, no. 22, pp. 1654–1669, 2023, doi: 10.1161/CIRCULATIONAHA.122.062021.

M. N. Kosiborod et al., “Effects of empagliflozin on symptoms, physical limitations, and quality of life in patients hospitalized for acute heart failure: Results from the EMPULSE trial,” Circulation, vol. 146, no. 4, pp. 279–288, 2022, doi: 10.1161/CIRCULATIONAHA.122.059725.

C. G. Santos-Gallego et al., “Randomized Trial of Empagliflozin in Nondiabetic Patients With Heart Failure and Reduced Ejection Fraction,” J. Am. Coll. Cardiol., vol. 77, no. 3, pp. 243–255, 2021, doi: 10.1016/j.jacc.2020.11.008.

M. E. Nassif et al., “Empagliflozin effects on pulmonary artery pressure in Patients With Heart Failure: Results from the EMBRACE-HF trial,” Circulation, vol. 143, no. 17, pp. 1673–1686, 2021, doi: 10.1161/CIRCULATIONAHA.120.052503.

J. Jensen et al., “Twelve weeks of treatment with empagliflozin in patients with heart failure and reduced ejection fraction: A double-blinded, randomized, and placebo-controlled trial,” Am. Heart J., vol. 228, pp. 47–56, 2020, doi: 10.1016/j.ahj.2020.07.011.

L. Xie, S. Li, X. Yu, Q. Wei, F. Yu, and J. Tong, “DAHOS Study: Efficacy of dapagliflozin in treating heart failure with reduced ejection fraction and obstructive sleep apnea syndrome - A 3-month, multicenter, randomized controlled clinical trial.,” Eur. J. Clin. Pharmacol., vol. 80, no. 5, pp. 771–780, May 2024, doi: 10.1007/s00228-024-03643-3.

F. Ilyas et al., “Acute pleiotropic effects of dapagliflozin in type 2 diabetic patients with heart failure with reduced ejection fraction: a crossover trial,” ESC Hear. Fail., vol. 8, no. 5, pp. 4346–4352, 2021, doi: 10.1002/ehf2.13553.

A. Fatima et al., “Exploring the Cardiovascular Benefits of Sodium-Glucose Cotransporter-2 (SGLT2) Inhibitors: Expanding Horizons Beyond Diabetes Management,” Cureus, vol. 2, no. 9, 2023, doi: 10.7759/cureus.46243.

I. Hasan, T. Rashid, V. Jaikaransingh, C. Heilig, E. M. Abdel-Rahman, and A. S. Awad, “SGLT2 inhibitors: Beyond glycemic control,” J. Clin. Transl. Endocrinol., vol. 35, no. February, p. 100335, 2024, doi: 10.1016/j.jcte.2024.100335.

A. Di Costanzo, G. Esposito, C. Indolfi, and C. A. M. Spaccarotella, “SGLT2 Inhibitors: A New Therapeutical Strategy to Improve Clinical Outcomes in Patients with Chronic Kidney Diseases,” Int. J. Mol. Sci., vol. 24, no. 10, 2023, doi: 10.3390/ijms24108732.

K. F. Docherty et al., “Effect of Dapagliflozin on Outpatient Worsening of Patients With Heart Failure and Reduced Ejection Fraction: A Prespecified Analysis of DAPA-HF,” Circulation, vol. 142, no. 17, pp. 1623–1632, 2020, doi: 10.1161/CIRCULATIONAHA.120.047480.

D. Fitchett et al., “Empagliflozin Reduced Mortality and Hospitalization for Heart Failure across the Spectrum of Cardiovascular Risk in the EMPA-REG OUTCOME Trial,” Circulation, vol. 139, no. 11, pp. 1384–1395, 2019, doi: 10.1161/CIRCULATIONAHA.118.037778.

F. Jyotsna et al., “A Systematic Review and Meta-Analysis on the Efficacy and Safety of Finerenone Therapy in Patients with Cardiovascular and Chronic Kidney Diseases in Type 2 Diabetes Mellitus,” Cureus, vol. 2, no. 7, 2023, doi: 10.7759/cureus.41746.

H. J. L. Heerspink et al., “Dapagliflozin in Patients with Chronic Kidney Disease,” N. Engl. J. Med., vol. 383, no. 15, pp. 1436–1446, 2020, doi: 10.1056/nejmoa2024816.