Cardiology · Nephrology ·
Dapagliflozin Improved eGFR Slope in Heart Transplant Recipients
In the multicenter, double-blind DAPARHT randomized trial, 430 heart transplant recipients received dapagliflozin or placebo for 12 months. Dapagliflozin was associated with a modestly better eGFR slope; adverse-event rates were similar between groups.
- 430 recipients randomized; 424 included in the analysis.
- eGFR slope favored dapagliflozin by 1.7 mL/min/1.73 m².
- Similar adverse-event rates were reported between groups.
- Follow-up was 12 months; clinical endpoints were not provided.
Progressive kidney disease is common after heart transplantation, including in association with calcineurin inhibitor exposure and pre-existing comorbidities. The DAPARHT trial randomized 430 adults at six Northern European transplant centers to dapagliflozin 10 mg daily or matching placebo. Participants were at least one year post-transplant and had a baseline eGFR of at least 25 mL/min/1.73 m². The primary endpoint was eGFR slope during 12 months of blinded treatment; 424 participants with at least one post-baseline measurement were included in the full analysis set.
From two weeks after treatment initiation to 12 months, eGFR changed by 2.0 mL/min/1.73 m² (95% CI, 1.0–3.1) with dapagliflozin and 0.3 (95% CI, −0.8 to 1.4) with placebo. The between-group difference was 1.7 mL/min/1.73 m² (95% CI, 0.1–3.3; P=0.03). Adverse events, including infections, occurred at similar rates, with no unexpected safety signals reported.
The findings suggest a modest improvement in a kidney-function measure in this population. The trial followed participants for 12 months and assessed eGFR slope; the supplied report does not provide evidence on longer-term kidney outcomes or other clinical endpoints. Results do not by themselves establish routine use in heart transplant recipients.
In practice
For adults at least one year after heart transplantation with eGFR ≥25 mL/min/1.73 m², this randomized trial found a modestly more favorable eGFR slope with dapagliflozin than placebo over 12 months. This is evidence of an effect on a kidney-function measure, not evidence in the supplied report of fewer kidney-failure events or other long-term clinical outcomes. The findings may inform consideration of the drug in this population, but do not establish routine use or long-term benefit.
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Circulation: Dapagliflozin for Renal Protection in Heart Transplant Recipients: A Randomized Clinical Trial ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.