There are no previous medications that change CVD outcomes in CHF with preserved ejection fracture (HFpEF). This includes Candesartan, Spironolactone and a neprilysin inhibitor with no success. This is the first medication to show benefit, a 21% reduction in the primary outcome of hospitalised HF or CV death (HR 0.79; P<0.001).1
Empagliflozin worked for patients at the lower and higher ends of the >40% range of EF and whether or not the patients had diabetes. Adverse events discontinuation of treatment occurred in 19.1% of patients in the empagliflozin group and 18.4% in the placebo group.
Uncomplicated genital and urinary tract infections and hypotension were more common in the empagliflozin group. Empagliflozin (Jardiance) is only funded in NZ for patients with diabetes on special authority. Individuals without diabetes can pay for it at about $80 per month.