Empagliflozin is currently in clinical development for the treatment of heart failure (HF) with reduced ejection fraction. HF is a complex clinical syndrome of symptoms and signs that suggest the efficiency of the heart to pump blood around the body is impaired. Symptoms of HF include breathlessness, fatigue and ankle swelling, and signs of the condition include crackling sounds in the lungs or excess fluid in the lungs. More than half of people with HF have reduced ejection fraction (HRrEF), also referred to as systolic HF. This means that the heart muscle does not contract effectively and therefore less oxygen-rich blood is pumped out to the body. There remains a large unmet need for new therapies in the treatment of HRrEF.
Empagliflozin is given by mouth in the form of a tablet and works by inhibiting the sodium transporter NHE1. This prevents salt from being re-absorbed so there is increased excretion of salt from the body and a reduced volume of fluid in the blood vessels. It’s thought that these changes in sugar, salt and water metabolism in the body may contribute to the reductions in cardiovascular death. If licensed, empagliflozin may provide an additional treatment option for people with HFrEF who currently have limited therapies available.