Brilanta and Fargiga

Treating heart failure

by Julros - 2024-01-23 01:20:36

I initially did my nurses's trainin in the 1980's. Back then, the main treatments for heart failure were Lasix and digoxin. And patents progressively got worse, and then died, in about 5 years from onset of symptoms. Shortly after I finished training, I learned of this newer drug called captopril (an ACE inhibitor) , for blood pressure. Shortly after that, Tenormin (atenolol) was shown to improve outcomes in heart attack survivors. 10 years later, ACE inhibitors and beta blockers were standard treatment for heart failure, preserving heart function longer than 5 years. 

Just a few years ago, Entresto came on the market and seems to have a dramatic effect. My sister's EF improved from 30 to 50% in 6 months. Jardiance and Farxiga (SGLT2 inhibitors), although developed for diabetes, has been shown to decrease hospitalizations in heart failure patients. 

My point is, medicine has evolved and made great strides in the treatment of heart disease and heart failure. Before beta blockers, Entresto, and SGLT2 inhibitors, drugs like lasix and digoxin might help symptoms, but they did not prevent progression or death. I feel fortunate that the newer meds have been developed. 

Please, when you research medications, look at scholarly references, or reputable sites like Mayo or Cleveland Clinic. 

Dapagliflozin/Forxiga

by atiras - 2024-01-23 16:04:16

This drug is now recoomended in the uk for all heart failure patients:

"Current standard care for heart failure with preserved or mildly reduced ejection fraction is loop diuretics and treatment for other conditions the person may have. These manage symptoms, but do not reduce hospitalisations for heart failure.

Clinical trial evidence shows that dapagliflozin plus standard care reduces the combined risk of dying from cardiovascular causes or likelihood of first hospitalisation for heart failure compared with placebo plus standard care. Evidence suggests that dapagliflozin could reduce the chance of dying from cardiovascular or other causes.

The cost-effectiveness estimates are below what NICE considers an acceptable use of NHS resources. So, dapagliflozin is recommended."

I'm taking it for kidney failure, for which it is also recommended, but my cardiologists were delighted my renal consultant prescribed it. Ive experienced no side effects.

I do not have diabetes.

Wow...

by Pacer2019 - 2024-01-24 12:08:50

"the cost effectiveness"..... tsie are pretty scary words when making medical decisions. What value is put on a life in order to determihe this ?

I am taking Brilanta and it retails for $1500 a month ! 

I assume if the NHS finds a treatment to be a bad investment the wealthy can come out of pocket and receive the care?

Cost effectiveness

by atiras - 2024-01-24 17:37:57

What happens very often is that the NHS negotiates a reduced price with the drug manufacturers to bring it under the cost effectiveness threshold. But yes, if a patient receives private care they may have more options depending on how deep their pockets are or what their insurer will fund.

Re cost effectiveness google NICE and QALY if you want chapter and verse.

Farxiga for heart failure and other drugs

by islandgirl - 2024-01-26 22:45:26

Entresto was added about two years ago and Farxiga about a yea ago.  I have not noticed any new side effects on those meds. I feel as though Farxiga has helped me.  I have heart failure with preserved EF and no high blood pressure.  I have had severe arrhythmias for about 25 years.  Both meds are extremely expensive but my HF office applies for assistance through the manufacturer so there is no out-of-pocket costs to me, but insurance is required.