National Institute for Health and Clinical Excellence (NICE)
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NICE draft guidance recommends new treatment for chronic heart failure

Up to 150,000 people in England with a type of chronic heart failure are set to benefit from a new treatment following its approval by NICE

NICE has today (18 May 2023) issued final draft guidance which recommends dapagliflozin (also called Forxiga and made by AstraZeneca) as an option for adults with symptomatic chronic heart failure with preserved or mildly reduced ejection fraction.

Heart failure with preserved or mildly reduced ejection fraction happens when the left side of the heart doesn't fill properly with blood during the diastolic (filling) phase. This means the heart is unable to pump enough blood to meet the body’s needs.

Dapagliflozin is the first NICE-recommended treatment for this type of heart failure.

Evidence from a clinical trial shows that adding dapagliflozin to standard care with diuretics (sometimes called ‘water tablets’) reduces the combined risk of dying from cardiovascular causes or the likelihood of needing to go to hospital with heart failure for the first time compared with a dummy treatment plus standard care.

Helen Knight, director of medicines evaluation at NICE, said: “Until now there have been no treatments available to delay or slow the progression of this type of heart failure. The committee heard from patient and clinical experts who described how the lack of research and available treatments in this area led to a lack of hope and support that impacts the quality of life and mental health of people with the condition. And we know that chronic heart failure also places a significant burden on the NHS through hospitalisations.

“We’re committed to bring the best care to people fast, while at the same time ensuring value for money for the taxpayer. Today’s draft guidance means that for the first time there is an effective treatment available on the NHS for people with this type of heart failure. Not only does dapagliflozin have the potential to help them live well for longer, but it could also save the NHS money and free up space by reducing their risk of having to go to hospital for unplanned emergency treatment.”

More than 550,000 people in England have heart failure and around 50% have preserved or mildly reduced ejection fraction (of who up to 150,000 would be eligible for treatment with dapagliflozin). There were 94,185 hospitalisations in England for heart failure in 2019/20, making it one of the leading causes of avoidable hospitalisations. Around a quarter of people with heart failure die within the first year and over half within 5 years.

Read the final draft guidance on dapagliflozin here:

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