AstraZeneca + Saint Luke’s Mid America Heart Institute initiate phase III DARE-19 trial with Farxiga in COVID-19 patients.

AstraZeneca and Saint Luke’s Mid America Heart Institute have initiated a randomised, global Phase III trial to assess the potential of Farxiga (dapagliflozin) as a treatment in patients hospitalised with COVID-19 who are at risk of developing serious complications, such as organ failure.

The goal of the trial, called DARE-19, is to assess whether Farxiga, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, can reduce the risk of disease progression, clinical complications, and death due to COVID-19 in patients who also have cardiovascular (CV), metabolic or kidney risk factors. Cardiac, renal and metabolic comorbidities have been associated with poor outcomes and death in COVID-19 patients. The trial design is supported by extensive data on the protective effect of Farxiga in patients with heart failure with reduced ejection fraction (HFrEF), chronic kidney disease (CKD) or type 2 diabetes (T2D).

Mikhail N. Kosiborod, M.D., cardiologist at Saint Luke’s Mid America Heart Institute, Vice President of Research at Saint Luke’s Health System, and principal investigator of DARE-19 said: “Dapagliflozin has demonstrated cardio and renal protective benefits and improved outcomes in high-risk patients with type-2 diabetes, heart failure with reduced ejection fraction, and chronic kidney disease. Patients with COVID-19 and underlying cardiometabolic disease appear to be at the highest risk of morbid complications. Through DARE-19, we hope to decrease the severity of illness, and prevent cardiovascular, respiratory and kidney decompensation, which are common in patients with COVID-19.”

The DARE-19 trial is open for enrolment in the US and other European countries with a high COVID-19 burden and aims to recruit approximately 900 patients.

DARE-19 is an international, parallel-group, randomised, double-blind, placebo-controlled, investigator-sponsored Phase III trial evaluating the efficacy and safety of Farxiga in addition to background local standard of care therapy, on the risk of all-cause death or disease progression and complications in adults who are hospitalised with COVID-19 at the time of trial enrollment. Patients enrolled in DARE-19 also have a medical history of hypertension (HTN), atherosclerotic CV disease, heart failure with reduced or preserved ejection fraction, T2D or CKD Stage III to IV. The primary efficacy outcome of the trial is time to first occurrence of death from any cause or new/worsened organ dysfunction through 30 days of follow-up. Some of the patients at highest risk of COVID-19 complications appear to be those with cardiometabolic disease. CV complications, including acute myocardial injury and heart failure (HF) are common in COVID-19, and appear to be key drivers of poor outcomes and death especially in patients with pre-existing CV disease and/or CKD.