Step by Step

INTRODUCTION

NABP and DOB Data Collection

PULSE: 1/29/2020 - SGLT-2 Inhibitors: A Potential Sweet Spot Beyond Patients With Diabetes?

QUIZ

EVALUATION

CERTIFICATE

INTRODUCTION

Credit Hours: Pharmacy 1.00

Target Audience:

Who should attend:

  • Clinical faculty from the University of Pittsburgh School of Pharmacy
  • Clinical staff pharmacists employed by the University of Pittsburgh Medical Center and deployed throughout the hospital campus in unit based roles and centrally in the department of pharmacy's main pharmacy
  • Student pharmacy interns currently working within the department of pharmacy
  • Certified Pharmacy Technicians

Abstract
Heart failure with reduced ejection fraction (HFrEF) is associated with significant morbidity and mortality. Current guideline directed medical therapy (GDMT) includes a renin-angiotensin inhibitor, beta-blocker, and aldosterone antagonist, all which have been shown to provide reduction in morbidity and mortality. The landmark Cardiovascular outcomes trials (EMPA-REG, CANVAS, and DECLARE-TIMI 58) provide evidence for three sodium-glucose co-transporter 2 (SGLT2) inhibitors in reducing heart failure hospitalizations in patients with diabetes.

Recent data highlights a benefit with use of the SGLT2 inhibitor dapagliflozin in patients without diabetes with HFrEF when added to GDMT. This presentation will examine the current literature for SGLT2 inhibitor outcomes in heart failure and assess its place in therapy for heart failure management.

Educational Objectives:

Upon successful completion of this continuing pharmacy education program, the participant should be able to:

  • Discuss the mechanism, indications, dosing, and adverse effects of sodium-glucose co-transporter 2 inhibitors (SGLT2-l).
  • Recognize the role of SGLT2 inhibitors in heart failure management based on reviewed literature.
  • Identify patients who would be appropriate candidates for SGLT2 inhibitor initiation in heart failure management.
    • Pharmacy Continuing Education Credits
    This program is sponsored by the University of Pittsburgh Center for Continuing Education in the Health Sciences. The University of Pittsburgh Center for Continuing Education in the Health Sciences is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a Provider of continuing pharmacy education. The assigned universal program number(s) is JA4008223-0000-20-010-H01-P.

    This module is a webcast of an ACPE approved live presentation. The minimum credit awarded for this module (1 contact hour) is determined by the length of the entire live presentation inclusive of the post-test.

Suggested Additional Reading:

  1. Joffe DL, SLT2 Inhibitors: A New Class of Diabetes Medications. Diabetes in Control. 2018.
  2. Lam C, Chandramouli C, Ahooja V, et al. SGLT-2 Inhibitors in Heart Failure: Current Management, Unmet Needs, and Therapeutic Prospects. Journal of the American Heart Association. 2019; 8:e013389
  3. Yancy C, Jessup M, Bozkurt B. et al. 2013 ACCF/AHA Guideline for the Management of Heart Failure. Journal of the American College of Cardiology. 2013. 62(16): e147-239
  4. ACC/AHA Task Force Members. 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure. Circulation. 2017; 136: e137-e161.
  5. Scheen A. Cardiovascular Effects of New Oral Glucose- Lowering Agents. Circulation Research. 2018; 122: 1439- 1459
  6. Verma S. Potential Mechanisms of Sodium- Glucose Co-Transporter 2 Inhibitor-Related Cardiovascular Benefits. AM J Cardiol 2019; 124: S36-S44
  7. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. NEJM. 2015. 373(22): 2117-28
  8. Neal B, Perkovic V, Mahaffey K, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. NEJM. 2017; 377: 644-657.
  9. Wiviott SD, Raz I, Bonaca M, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. NEJM. 2019; 380: 347-357
  10. Nassif M, Windsor S, Tang F, et al. Dapagliflozin Effects on Biomarkers, Symptoms, and Functional Status in Patients With Heart Failure With Reduced Ejection Fraction. Circulation. 2019; 140: 1463-1476
  11. McMurray J, Soloman S, Inzucchi S, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. NEJM. 2019; 381: 1995-2008.
  12. Healio Cardiology today. EMPERIAL top-line results: Empagliflozin for HFpEF, HFrEF fails to improve exercise ability. December 2019. https://www.healio.com/cardiology/hf-transplantation/news/online

Authors:
Precious Dadzie, PharmD — Ambulatory Care Resident, Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy
No relationships with industry relevant to the content of this educational activity have been disclosed.
No other members of the planning committee, speakers, presenters, authors, content reviewers and/or anyone else in a position to control the content of this education activity have relevant financial relationships with any companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

The certificate issued at the end of this course is not official, it only indicates you obtained a passing grade for this activity.

The ACPE and the National Association of Boards of Pharmacy (NABP) have developed a continuing pharmacy education (CPE) tracking service, CPE Monitor, that will authenticate and store data for completed CPE units received by pharmacists and pharmacy technicians from ACPE-accredited providers.

ACPE credit for participation in any pharmacist and/or technician achieved from this website is entered quarterly. Please allow 60 days from date of completion, for your credits to be added to the CPE Monitor.

For questions regarding NABP profile creation and maintenance, as well as the reporting process to the state boards of pharmacy, please contact NABP Customer Service at 847/391-4406, Monday-Friday between 8:30 AM and 5 PM central time.

The University of Pittsburgh is an affirmative action, equal opportunity institution.