Recommended Citation
Craven A, Lange A, Nelson McMillan K. Evaluating the Use of Empagliflozin in Pediatric Heart Failure. Presented at Scientific Day; May 21, 2025; Park Ridge, IL.
Abstract
Background/Significance:
Pediatric heart failure (HF) remains a condition with significant morbidity and mortality, presenting a critical challenge in pediatric cardiology. Sodium-glucose cotransporter 2 inhibitors (SGLT2i), initially developed for managing type II diabetes, have demonstrated considerable benefits in adult patients with HF, including reductions in mortality and hospitalization rates. At Advocate Children’s Hospital, empagliflozin is the SGLT2i available on formulary. The paucity of data on empagliflozin in pediatric patients presents a significant gap in the literature.
Purpose:
This study aims to address this gap by evaluating the safety and efficacy of empagliflozin in children with HF.
Methods:
This single-center, retrospective observational study of current practice will review the use of empagliflozin in pediatric patients with HF. A report generated from the electronic health record was used to identify potential patients, and patients were included if they were 1 day through 18 years old with HF who were initiated on empagliflozin at Advocate Children’s Hospital Oak Lawn, between January 2022 and December 2024. Patients were excluded if the duration of empagliflozin was less than 7 days and if the indication was not HF. The primary endpoint is a reduction in diuretic use. Secondary endpoints include assessing safety and change in HF class.
Data will be collected at initiation and the last recorded follow-up. Key data points will include baseline characteristics, changes in diuretic requirements, adverse events, and other relevant clinical outcomes.
Results:
Heart failure etiologies included dilated cardiomyopathy (3/25), single ventricle physiology (14/25), diastolic heart failure (6/25), and Marfan syndrome (2/25). Therapy was initiated at 0.1 mg/kg and titrated to 0.2 mg/kg daily. Over the course of treatment, loop and thiazide diuretic requirements decreased by 36% and 20%, respectively. NT-proBNP levels showed a significant reduction, with median values decreasing from 3,916 pg/mL at baseline to 1,532 pg/mL at the latest follow-up (P = 0.008). No adverse events were reported.
Conclusion:
SGLT2i therapy appeared safe with no reported adverse drug reactions, demonstrating improvements in cardiac biomarkers, stable renal function, and a decreased need for diuretics. These findings help support the potential role of SGLT2i in the management of HF in pediatric patients; however, further studies are warranted to define the safety and efficacy of this therapy in this vulnerable population.
Presentation Notes
Presented at Scientific Day; May 21, 2025; Park Ridge, IL.
Full Text of Presentation
wf_yes
Document Type
Poster
Evaluating the Use of Empagliflozin in Pediatric Heart Failure
Background/Significance:
Pediatric heart failure (HF) remains a condition with significant morbidity and mortality, presenting a critical challenge in pediatric cardiology. Sodium-glucose cotransporter 2 inhibitors (SGLT2i), initially developed for managing type II diabetes, have demonstrated considerable benefits in adult patients with HF, including reductions in mortality and hospitalization rates. At Advocate Children’s Hospital, empagliflozin is the SGLT2i available on formulary. The paucity of data on empagliflozin in pediatric patients presents a significant gap in the literature.
Purpose:
This study aims to address this gap by evaluating the safety and efficacy of empagliflozin in children with HF.
Methods:
This single-center, retrospective observational study of current practice will review the use of empagliflozin in pediatric patients with HF. A report generated from the electronic health record was used to identify potential patients, and patients were included if they were 1 day through 18 years old with HF who were initiated on empagliflozin at Advocate Children’s Hospital Oak Lawn, between January 2022 and December 2024. Patients were excluded if the duration of empagliflozin was less than 7 days and if the indication was not HF. The primary endpoint is a reduction in diuretic use. Secondary endpoints include assessing safety and change in HF class.
Data will be collected at initiation and the last recorded follow-up. Key data points will include baseline characteristics, changes in diuretic requirements, adverse events, and other relevant clinical outcomes.
Results:
Heart failure etiologies included dilated cardiomyopathy (3/25), single ventricle physiology (14/25), diastolic heart failure (6/25), and Marfan syndrome (2/25). Therapy was initiated at 0.1 mg/kg and titrated to 0.2 mg/kg daily. Over the course of treatment, loop and thiazide diuretic requirements decreased by 36% and 20%, respectively. NT-proBNP levels showed a significant reduction, with median values decreasing from 3,916 pg/mL at baseline to 1,532 pg/mL at the latest follow-up (P = 0.008). No adverse events were reported.
Conclusion:
SGLT2i therapy appeared safe with no reported adverse drug reactions, demonstrating improvements in cardiac biomarkers, stable renal function, and a decreased need for diuretics. These findings help support the potential role of SGLT2i in the management of HF in pediatric patients; however, further studies are warranted to define the safety and efficacy of this therapy in this vulnerable population.
Affiliations
Advocate Christ Medical Center, Advocate Children's Hospital