Heart failure affects more than 500,000 people in the Netherlands alone, and that number is expected to grow. For patients with the condition, the heart cannot pump blood effectively, leading to severe shortness of breath, fatigue, and repeated hospitalizations. A drug that costs less than ten cents a day may now offer a meaningful new option.
Three studies led by cardiologists at Universitair Medisch Centrum Groningen found that low-dose digoxin reduced heart failure hospitalizations by an average of 25 percent. The findings were published in Nature Medicine and the Journal of the American Medical Association and were presented at the ESC Heart Failure Congress in Barcelona, according to a report by Science Daily.
Digoxin is a centuries-old heart drug that had largely fallen out of favor. Standard heart failure care currently relies on a combination of four medications, which cardiologists refer to as the Fantastic Four. Researchers at UMCG have long studied whether digoxin could serve as a fifth treatment alongside that combination.
One of the three studies followed 1,000 heart failure patients at 43 centers across the Netherlands. Half received low-dose digoxin in addition to their usual treatment for an average of three years. The other half received a placebo. Among those taking digoxin, deaths from cardiovascular disease and worsening heart failure fell by 19 percent, though that result alone did not reach statistical significance.
To strengthen the findings, the researchers combined their data with results from two earlier studies in a meta-analysis, producing a much larger patient pool. With that expanded data, they found digoxin produced a statistically significant benefit even among patients already taking all four standard heart failure medications. The clearest result was the 25 percent reduction in hospital admissions. Low-dose digoxin was also found to be safe and relatively easy to use.
A third study followed approximately 600 of the original 1,000 participants. Researchers found that patients who had been taking digoxin and then stopped experienced a worsening of outcomes. The finding suggests that stopping the drug carried real consequences for patients who had been benefiting from it.
The UMCG cardiologists leading the research, Dirk Jan van Veldhuisen, Kevin Damman, and Peter van der Meer, said they believe the findings could eventually influence heart failure treatment guidelines and make the inexpensive medication available to many more patients worldwide.
