Efficacy, safety and regulatory status of SGLT2 inhibitors: focus on canagliflozin
Open Access
- 3 November 2014
- journal article
- research article
- Published by Springer Science and Business Media LLC in Nutrition & Diabetes
- Vol. 4 (11), e143
- https://doi.org/10.1038/nutd.2014.40
Abstract
Prevalence of diabetes mellitus is inc6reasing, with a burden of 382 million patients worldwide at present (more than the entire US population). The International Diabetes Federation anticipates an increase up to 592 million patients by 2035. Another major problem arises from the fact that just 50% of patients with type 2 diabetes mellitus are at target glycaemic control with currently available medications. Therefore, a clear need for new therapies that aim to optimize glycaemic control becomes evident. Renal sodium-linked glucose transporter 2 inhibitors are new antidiabetic drugs with an insulin-independent mechanism of action. They pose one remarkable advantage compared with already established antidiabetics: increasing urinary glucose excretion without inducing hypoglycaemia, thereby promoting body weight reduction due to loss of ~300 kcal per day. This review focuses on canagliflozin, which was the first successful compound of this class to be approved by both the US Food and Drug Administration and the European Medicines Agency in 2013. Clinical trials showed promising results: enhancing glycaemic control was paralleled by reducing body weight and systolic and diastolic blood pressure. Nevertheless, some safety concerns remain, such as genital mycotic infections, urinary tract infections and cardiovascular risks in vulnerable patients, which will be closely monitored in several post-authorization safety studies.Keywords
This publication has 51 references indexed in Scilit:
- Efficacy and safety of canagliflozin versus glimepiride in patients with type 2 diabetes inadequately controlled with metformin (CANTATA-SU): 52 week results from a randomised, double-blind, phase 3 non-inferiority trialThe Lancet, 2013
- Efficacy and safety of canagliflozin compared with placebo and sitagliptin in patients with type 2 diabetes on background metformin monotherapy: a randomised trialDiabetologia, 2013
- Efficacy and safety of canagliflozin monotherapy in subjects with type 2 diabetes mellitus inadequately controlled with diet and exerciseDiabetes, Obesity and Metabolism, 2013
- A novel approach to control hyperglycemia in type 2 diabetes: Sodium glucose co-transport (SGLT) inhibitors. Systematic review and meta-analysis of randomized trialsAnnals of Medicine, 2011
- Biology of Human Sodium Glucose TransportersPhysiological Reviews, 2011
- Glucose transport by human renal Na+/d-glucose cotransporters SGLT1 and SGLT2American Journal of Physiology-Cell Physiology, 2011
- SGLT2 inhibition — a novel strategy for diabetes treatmentNature Reviews Drug Discovery, 2010
- 10-Year Follow-up of Intensive Glucose Control in Type 2 DiabetesThe New England Journal of Medicine, 2008
- Efficacy and Safety of Incretin Therapy in Type 2 DiabetesJAMA, 2007
- SLC5A9/SGLT4, a new Na+-dependent glucose transporter, is an essential transporter for mannose, 1,5-anhydro-D-glucitol, and fructoseLife Sciences, 2005