2.5.3. SGLT2 inhibitor (Heart Failure)

For K&M Implementation of NICE TA’s – SGLT2 inhibitors (Dapagliflozin & Empagliflozin) in the treatment of chronic heart failure  Click Here (Guidance page)

For NICE TA679  which recommends dapagliflozin as an option for treating symptomatic chronic heart failure with reduced ejection fraction Click Here (Guidance page)

In order to ensure clarity for clinicians and promote equitable access, the Kent and Medway Medicines Optimisation Team recommends that:

1. Dapagliflozin, when used to treat chronic heart failure with reduced ejection fraction, is initiated by/on the advice of a heart failure specialist, with follow on prescribing in primary care.

2. Where specialist community heart failure teams exist, dapagliflozin may be initiated by the team following consultation with and continued oversight by a (consultant led) specialist heart failure multidisciplinary team (MDT), with a clear audit trail of such consultation.

3. For patients with comorbidities e.g. diabetes, multi-speciality MDTs would be appropriate.

4. Monitoring requirements and discontinuation criteria should be set out at initiation and clearly communicated to the clinician who continues with dapagliflozin prescribing.

Dapagliflozin

for treating chronic heart failure with preserved or mildly reduced ejection fraction- Recommended

For NICE TA902  where Dapagliflozin is recommended, within its marketing authorisation, as an option for treating symptomatic chronic heart failure with preserved or mildly reduced ejection fraction in adults. Click Here (Guidance page)

SGLT2 -  Chronic Kidney Disease (CKD) in Adults 

For Primary Care Guidance -SGLT2 inhibitors for Chronic Kidney Disease (CKD) in Adults and NICE TA775  Dapagliflozin for treating chronic kidney disease  Click Here (Guidance page)

Empagliflozin 

For NICE TA773  Empagliflozin for treating chronic heart failure with reduced ejection fraction 
and
For NICE TA929  Empagliflozin for treating chronic heart failure with preserved or mildly reduced ejection fraction
and
For NICE TA942  Empagliflozin for treating chronic kidney disease

Click Here (Guidance page)