A Medical Literature Review on Canagliflozin and Dapagliflozin and the Role of SGLT2 inhibitors in Diabetic Management

Deepu Daniel,Natasha Bray

doi:10.11131/2015/101128

Abstract

Diabetes is one of the most common diseases encountered in both the outpatient and inpatient settings. According to data from the 2011 National Diabetes Fact Sheet, approximately 8.3% (25.8 million) of the entire American population have diabetes. Of this population, about 72.9% (18.8 million) have been clinically diagnosed while an estimated 27.1% (7.0 million) remain undiagnosed. According to the study Economic Costs of Diabetes in the U.S. in 2012, the total national cost of diagnosed diabetes, including direct medical cost and reduced productivity was nearly $245 billion. Extensive research efforts have gone into developing new pharmacologic agents to treat diabetes. The newest medications recently approved by the FDA are the SGLT2 inhibitors. This article will explain the mechanism of the action of this class of drugs along with their specific role in diabetic management. This article will focus on canagliflozin and dapagliflozin, the two most well researched and studied drugs of SGLT2 inhibitors, both of which have been approved for use by the Food and Drug Administration. Some of the major trials concerning both of these drugs will be presented in this article.

Highlights

The study demonstrated that canigliflozin added on to metformin showed significant improvement in glycemic control and weight loss
SGLT2 inhibitors are the newest group of anti-diabetic medications on the market
The two most extensively studied drugs in this class have been canagliflozin and dapagliflozin, both of which have been approved by the FDA for use in the United States

Summary

Introduction

These twenty-four week placebo controlled phase 3 trials all showed Dapagliflozin to decrease baseline HgA1c and fasting plasma glucose (FPG) levels when used as monotherapy or as adjunctive therapy to metformin, pioglitazone, glimepiride, or insulin. A double blind placebo controlled study of 546 patients treated with Dapagliflozin at 2.5, 5, 10 mg, or placebo in addition to metformin (≥ 1500 mg/day) for a 24 week period demonstrated a decrease in baseline HgA1C of −0.67, −0.70, −0.84, and −0.30%, P < 0.05 [11]. 65.2% of the patients in the dapagliflozin treated groups showed an average decrease from baseline HgA1c ≥0.5% compared to 15.8% of the placebo group.

Results

Conclusion