HTA, DM2,

IECAs, ARA II, iSGLT2

y

COVID-19 Vivencio Barrios Alonso

Hospital Universitario Ramón y Cajal

Universidad de Alcalá

Madrid

Conflictos de interés

Ponente/consultor para:

Abbott; Amgen; Amstrong; AstraZeneca; Bayer Schering Pharma; Boehringer Ingelheim

Pharmaceuticals GmbH; Bristol-Myers Squibb; Daiichi Sankyo Europe GmbH; Lilly Pharma; Ferrer

International SA; Menarini Group Farma; Mundipharma-Janssen, Novartis AG; NovoNordisk; Pfizer;

Recordati Pharma; Roche Pharma; Sanofi Pharma; Servier Laboratories; Takeda Pharmaceuticals

Imai K, et al. Nature 2005;436(7047):112-16

From: Association of Use of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II

Receptor Blockers With Testing Positive for Coronavirus Disease 2019 (COVID-19)

JAMA Cardiol. Published online May 05, 2020. doi:10.1001/jamacardio.2020.1855

Association of ACEI and ARB With Results of SARS-CoV-2 Testing (Primary Outcome) and Secondary Clinical Outcomes: Overlap Propensity Score Weighted–Analysis

ORs With 95% CIsACEI indicates angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blocker; ICU, intensive care unit; OR, odds ratio; SARS-CoV-2,

severe acute respiratory syndrome coronavirus 2.

Figure Legend:

Concepción Peiró. Circulation. Substituting Angiotensin-(1-7) to Prevent Lung

Damage in SARS-CoV-2 Infection?, Volume: 141, Issue: 21, Pages: 1665-1666,

DOI: (10.1161/CIRCULATIONAHA.120.047297) © 2020 American Heart Association, Inc.

Lancet Diabetes Endocrinol 2020, April 23; doi: 10.1016/S2213-8587(20)30152-2

Adaptado de: Bornstein SR et al.

Lancet Diabetes Endocrinol 2020; doi: 10.1016/S2213-8587(20)30152-2

Considerations for glucose-lowering therapies in patients with

suspected or COVID-19-positive patients with T2D

If glucose-lowering therapies are discontinued, the alternative treatment of choice

(where this option is feasible) is insulin

SGLT2

inhibitors

• Continue for outpatients without symptoms of infection

or without evidence of a serious course of COVID-19

• Stop temporarily in patients with COVID-19 in case of

acute illnesses that can cause dehydration and follow

sick-day rules

• Avoid initiating therapy during respiratory illness

Placebo

Dapagliflozin 10 mg

1:1

Do

ub

le-b

lin

d

900 patients • ≥18 years of age

• Hospitalized with confirmed or strongly suspected COVID-19

Randomization

Day 0 30 days

Primary Endpoint

Time to first occurrence of either

death from any cause or

new/worsened organ dysfunction*

through 30 days of follow up

DARE-19 An international, multicenter, randomized, double-blind placebo controlled, phase III study evaluating the efficacy and safety of Dapagliflozin in respiratory failure in patients with COVID-19

“To go fast, go alone.

“To go far, go together.”

-African Proverb