Canagliflozin : something new for type 2 diabetes, but is it safe and efficacious?

Doggrell, Sheila & McIntyre, Kerry (2014) Canagliflozin : something new for type 2 diabetes, but is it safe and efficacious? Expert Opinion on Pharmacotherapy, 15(3), pp. 437-441.

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Abstract

Evaluation of Inagaki N, Kondo K, Yoshinari T, et al. Efficacy and safety of canagliflozin in Japanese patients with type 2 diabetes: a randomized, double-blind, placebo-controlled, 12-week study. Diabetes Obes Metab 2013. [Epub ahead of print] and Cefalu WT, Leiter LA, Yoon KH, et al. Efficacy and safety of canagliflozin versus glimepiride in patients with type 2 diabetes inadequately controlled with metformin (CANTATA-SU): 52 week results from a randomized, double-blind, phase 3 non-inferiority trial. Lancet 2013;382:941-50

INTRODUCTION

Inhibition of the sodium-glucose cotransporter 2 (SGLT2), to promote the excretion of glucose, is a new paradigm in the treatment of type 2 diabetes.

AREAS COVERED

Canagliflozin is an SGLT2 inhibitor, which has been the subject of two recent clinical trials, which are evaluated.

EXPERT OPINION

Studies with canagliflozin, in subjects with type 2 diabetes, have shown that its use is associated with reductions in HbA1c and body weight and small reductions in blood pressure and triglycerides, while increasing high-density lipoprotein cholesterol and low-density lipoprotein cholesterol. As monotherapy in Japanese subjects, or in comparison with glimepiride in CANTATA-SU (CANagliflozin Treatment and Trial Analysis versus SUlphonylurea), canagliflozin causes a low incidence of hypoglycemia, and this is an advantage over glimepiride. However, one of the disadvantages with canagliflozin, which was also highlighted in CANTATA-SU, is that canagliflozin can cause urogenital infections, which are not observed with other antidiabetic drugs. The Federal Drug Administration has recently approved canagliflozin for use in type 2 diabetes, while directing that a clinical outcome safety trial be undertaken. We are concerned that canagliflozin has been approved for use in type 2 diabetes prior to a clinical outcome study of efficacy being undertaken and without the outcome of further safety testing.

Impact and interest:

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ID Code: 78687
Item Type: Journal Article
Refereed: Yes
Keywords: canagliflozin, type 2 diabetes
DOI: 10.1517/14656566.2014.868885
ISSN: 1744-7666
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PHARMACOLOGY AND PHARMACEUTICAL SCIENCES (111500)
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Copyright Owner: Copyright 2014 Informa UK, Ltd.
Copyright Statement: Reproduction in whole or in part not permitted
Deposited On: 17 Nov 2014 00:46
Last Modified: 05 Mar 2015 17:53

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