Objective  To evaluate the effectiveness, safety and economy of dapagliflozin in chronic heart failure (CHF) using rapid health technology assessment to provide an evidence-based basis for clinical drug selection and decision-making.

Methods  PubMed, Embase, Web of Science, The Cochrane Library, CNKI, WanFang Data and the Health Technology Assessment (HTA) websites and databases were systematically searched to collect high-quality clinical evidence and economic evaluation litera-ture of dapagliflozin in the treatment of CHF, from the inception to July 24, 2021. Two reviewers inde-pendently identified studies, extracted data, assessed the quality of included studies, and descriptive analyzed and summarised the results.

Results  A total of 17 literatures were included, involving 6 sys-tematic reviews/Meta-analysis and 11 pharmacoeconomic studies. The analysis results of effectiveness showed that compared with placebo, dapagliflozin could significantly reduce the all-cause mortality, the cardiovascular mortality and the hospitalization for heart failure in patients with CHF (P<0.05), while there was no significant effect on laboratory indicators such as left ventricular ejection fraction and N-telencephalic natriuretic peptide (P>0.05). The analysis results of safety displayed treatment with dapagliflozin could not increase the risk of hypoglycemia, volume depletion, urinary tract infection and renal impairment (P>0.05), and could improve the metabolic indicators, such as systolic blood pressure and body weight (P<0.05). There was no significant difference in efficacy and safety between different sodium-glucose cotransporter 2 inhibitors (SGLT2i) by the indirect comparative analysis. Considering the willingness payment threshold was different in different countries or regions and different payers, the analysis results of pharmacoeconomic studies that dapagliflozin had cost-effectiveness advantage, were consistent.

Conclusion  Dapagliflozin is an efficacious, safe and economic choice for CHF, while there is still a lack of clinical studies and evaluation analysis of head-to-head comparison between SGLT2i.

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