Dapagliflozin improved eGFR slope in 424 heart transplant recipients in the DAPARHT trial

Dapagliflozin, compared with placebo, improved the slope of estimated glomerular filtration rate (eGFR) from 2 weeks to 12 months of treatment in heart transplant recipients, according to endocrinologyadvisor.com. The results were presented at the American Heart Association (AHA) Scientific Sessions 2026 in Chicago, Illinois, held from November 6 to 9, 2026. thecardiologyadvisor.comendocrinologyadvisor.comthecardiologyadvisor.comOpen source ↗ The trial included 424 patients.

Trial design and participants

Progressive kidney disease is common in heart transplant recipients because of preexisting comorbidities and calcineurin inhibitor exposure. Evidence on the role of sodium-glucose cotransporter 2 (SGLT2) inhibitors in kidney function in this population is limited.

DAPARHT (Dapagliflozin for Renal Protection in Heart Transplant Recipients) is a double-blind, randomized, placebo-controlled trial. It enrolled adults at 6 heart transplant centers in Northern Europe. Patients with type 1 diabetes and an active malignancy or receiving cancer treatment, as well as those receiving SGLT2 inhibitors, were excluded.

Eligible patients had at least 1 eGFR measurement after baseline and an eGFR of 25 mL/min/1.73 m2 or greater at least 1 year after transplantation. They were randomly assigned 1:1 to 10 mg dapagliflozin or a matching placebo once daily. The primary endpoint was the eGFR slope from 2 weeks after treatment initiation to the end of the 12-month blinded treatment period. thecardiologyadvisor.comendocrinologyadvisor.comthecardiologyadvisor.comOpen source ↗

Of the 424 participants, 215 received dapagliflozin and 209 received placebo. Mean age was 53 years (SD 14), 29% were women, baseline eGFR was 67 mL/min/1.73 m2, and median time from transplantation was 7 years (IQR 3-13).

eGFR slope and adverse events

In the dapagliflozin group, the change in eGFR from 2 weeks to 12 months after treatment initiation was 2.0 mL/min/1.73 m2 (95% CI, 1.0-3.1), compared with 0.3 mL/min/1.73 m2 in the placebo group. The between-group difference was 1.7 mL/min/1.73 m2.

Adverse event rates were similar in the two groups: any adverse event occurred in 76.3% of patients in the dapagliflozin group and 71.1% in the placebo group. No unexpected safety signals occurred in either group. thecardiologyadvisor.comendocrinologyadvisor.comthecardiologyadvisor.comOpen source ↗

The study authors concluded that dapagliflozin, compared with placebo, improved the slope of the eGFR from 2 weeks to 12 months of treatment. The work was presented by Holmen S, Manintveld O, Damman K and colleagues (abstract FS.07).