Jardiance prevails where Entresto could not

Right now the only drug approved for heart failure with preserved ejection fraction is Novartis’s Entresto – and only in some patients. This could be about to change, with Lilly and Boehringer Ingelheim reporting a topline win in HFpEF today with their SGLT2 inhibitor Jardiance. The companies are saving details of the Emperor-Preserved trial for the European Society of Cardiology meeting in August, and the magnitude of benefit will be closely watched. By way of comparison, Entresto showed a 13% reduction in the risk of cardiovascular death and heart failure hospitalisations; this narrowly missed statistical significance but was enough for the FDA to broaden that drug’s label. Hopes will now be building for a class effect with the SGLT2s in HFpEF; a benefit had already been suggested with Lexicon’s SGLT1/2 inhibitor sotagliflozin, while the Deliver trial of Astrazeneca’s Farxiga is set to complete early next year. Jardiance, currently marketed for type 2 diabetes, is forecast to sell over $5bn by 2026, according to Evaluate Pharma sellside consensus, but this might soon get a bump. Lilly and Boehringer do not have too long to benefit from any heart failure approvals, though, with the drug set to come off patent in 2028.