Canagliflozin in the treatment of patients with type 2 diabetes mellitus
Authors:
Peter Galajda; Marián Mokáň
Authors place of work:
I. interná klinika JLF UK a UNM, Martin
Published in the journal:
Forum Diab 2024; 13(3): 147-151
Category:
Review Article
Summary
Sodium-glucose co-transporter 2 (SGLT2) inhibitors, gliflozins are a modern class of diabetic medications in the treatment of patients with type 2 diabetes mellitus (T2DM). Apart from good glycemic control, low risk of hypoglycemia and weight loss, canagliflozin has been shown to provide significant cardiovascular and nephroprotective benefit in patients with T2DM co-equal to other gliflozines (empagliflozin, dapagliflozin). Treatment with canagliflozin is potentially associated with lower risk of stroke due to inhibition of SGLT1. Incidence of adverse side effects such as increased risk of urinary infections, mainly vaginal candidosis in female, euglycemic ketoacidosis and volume depletion with hypotension is comparable in whole group of gliflozines.
Keywords:
type 2 diabetes mellitus – canagliflozin – sodium-glucose co-transporter 2 (SGLT2) inhibitors – cardiovascular and nephroprotective benefit – adverse effect – metabolic effect
Zdroje
Martinka E, Tkáč I, Mokáň M et al. Odporúčané postupy pre liečbu diabetes mellitus 2. typu – 2023. Forum Diab 2023; 12(2): 93–133.
[American Diabetes Association]. 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2024. Diabetes Care 2024; 47(Suppl 1): S158–S178. Dostupné z DOI: <http://dx.doi.org/10.2337/dc24-S009>. Erratum in Erratum: Diabetes Care 2024; 47(7): 1238. Dostupné z DOI: <http://dx.doi.org/10.2337/dc24-er07a>.
Sayour AA, Oláh A, Ruppert M et al. Effect of pharmacological selectivity of SGLT2 inhibitors on cardiovascular outcomes in patients with type 2 diabetes: a meta-analysis. Sci Rep 2024;1 4(1): 2188. Dostupné z DOI: <http://dx.doi.org/10.1038/s41598–024–52331-w>.
Stenlof K, Cefalu WT, Kim KA et al. Efficacy and safety of canagliflozin monotherapy in subjects with type 2 diabetes mellitus inadequately controlled with diet and exercise. Diabetes Obes Metab 2013; 15(4): 372–382. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12054>.
Wilding JP, Charpentier G, Hollander P et al. Efficacy and safety of canagliflozin in patients with type 2 diabetes mellitus inadequately controlled with metformin and sulphonylurea: a randomized trial. Int J Clin Pract 2013; 67(12): 1267–1282. Dostupné z DOI: <http://dx.doi.org/10.1111/ijcp.12322>.
Forst T, Guthrie R, Goldenberg R et al. Efficacy and safety of canagliflozin over 52 weeks in patients with type 2 diabetes on background metformin and pioglitazone. Diabetes Obes Metab 2014; 16(5): 467–477. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12273>.
Lavalle-Gonzalez FJ, Januszewicz A, Davidson J et al. Efficacy and safety of canagliflozin compared with placebo and sitagliptin in patients with type 2 diabetes on background metformin monotherapy: a randomized trial. Diabetologia 2013; 56(12): 2582–2592. Dostupné z DOI: <http://dx.doi.org/10.1007/s00125–013–3039–1>.
Schernthaner G, Gross JL, Rosenstock J et al. Canagliflozin compared with sitagliptin for patients with type 2 diabetes who do not have adequate glycemic control with metformin plus sulfonylurea: a 52-week randomized trial. Diabetes Care 2013; 36(9): 2508–2515. Dostupné z DOI: <http://dx.doi.org/10.2337/dc12–2491>.
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): a 52-week results from randomized, double-blind, phase 3 non-inferiority trial. Lancet 2013; 382(9896): 941–950. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(13)60683–2>.
Gorgojo-Martinez JJ, Ferreira-Ocampo PJ, Galdón Sanz-Pastor A et al. Effectiveness and tolerability of the intensification of canagliflozin dose from 100 mg to 300 mg daily in patients with type 2 diabetes in real life: The INTENSIFY Study. J Clin Med 2023; 12(13): 4248. Dostupné z DOI: <http://dx.doi.org/10.3390/jcm12134248>.
Rosenstock J, Chuck L, González-Ortiz M al. Initial combination therapy with canagliflozin plus metformin versus each component as monotherapy for drug-naïve type 2 diabetes. Diabetes Care 2016; 39(3): 353–362. Dostupné z DOI: <http://dx.doi.org/10.2337/dc15–1736>.
Li G, Zhang D, Ni J et al. Clinical efficacy of different doses of canagliflozin combined with metformin in the treatment of type 2 diabetes: Meta-Analysis. Altern Ther Health Med 2023; 29(7): 328–334.
Zaccardi F, Webb DR, Htike ZZ et al. Efficacy and safety of sodium-glucose co-transporter-2 inhibitors in type 2 diabetes mellitus: systematic review and network meta-analysis. Diabetes Obes Metab 2016; 18(8): 783–794. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.12670>.
Invokana (kanagliflozín). SPC. Dostupné z WWW: <https://ec.europa.eu/health/documents/community-register/2020/20200626148506/anx_148506_sk.pdf>.
Takebayashi K, Inukai T. Effect of sodium glucose cotransporter 2 inhibitors with low SGLT2/SGLT1 selectivity on circulating glucagon-like peptide 1 levels in type 2 diabetes mellitus. J Clin Med Res 2017; 9(9): 745–753. Dostupné z DOI: <http://dx.doi.org/10.14740/jocmr3112w>.
Pitt B, Steg G, Leiter LA et al. The role of combined SGLT1/SGLT2 inhibition in reducing the incidence of stroke and myocardial infarction in patients with type 2 diabetes mellitus. Cardiovasc Drugs Ther 2022; 36(3): 561–567. Dostupné z DOI: <http://dx.doi.org/10.1007/s10557–021–07291-y>.
Wang L, Liang C, Song X et al. Canagliflozin alters the gut, oral, and ocular surface microbiota of patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2023; 14: 1256292. Dostupné z DOI: <http://dx.doi.org/10.3389/fendo.2023.1256292>.
Zinman B, Wanner C, Lachin JM et al. [EMPAREG-OUTCOME Investigators]. Empagliflozine, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 2015; 373(22): 2117–2128. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1504720>.
Neal B, Perkovic V, Mahaffey KW et al. [CANVAS Program Collaborative Group]. Canagliflozine and cardiovascular and renal events in type 2 diabetes. N Engl J Med 2017; 377(7): 644–657. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1611925>.
Wiviott SD, Raz I, Bonaca MP et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2019; 380(4): 347–357. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1812389>.
Kosiborod M, Cavender MA, Fu AZ et al. Lower risk of heart Failure and death in patients initiated on SGLT-2 inhibitors versus other glucose-lowering drugs: The CVD-REAL study. Circulation 2017; 136(3): 249–259. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.117.029190>.
Ryan P, Buse JB, Schuemie MJ et al. Comparative effectiveness of canagliflozin, SGLT2 inhibitors and non-SGLT2 inhibitors on the risk of hospitalization for heart failure and amputation in patients with type 2 diabetes mellitus: A real-world meta-analysis of 4 observational databases (OBSERVE-4D). Diabetes Obes Metab 2018; 20(11): 2585–2597. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.13424>.
Chen JY, Pan HC, Shiao CC et al. Impact of SGLT2 inhibitors on patient outcomes: a network meta-analysis. Cardiovasc Diabetol 2023; 22(1): 290. Dostupné z DOI: <http://dx.doi.org/10.1186/s12933–023–02035–8>.
Perkovic EV, Jardine MJ, Neal B et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med 2019; 380 (24): 2295–2306. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1811744>.
Jardine MJ, Zhou Z, Mahaffey KW et al. Renal, cardiovascular, and safety outcomes of canagliflozin by baseline kidney function: a secondary analysis of the CREDENCE randomized trial. J Am Soc Nephrol 2020; 31(5): 1128–1139. Dostupné z DOI: <http://dx.doi.org/10.1681/ASN.2019111168>.
Tobe SW, Mavrakanas TA, Bajaj HS et al. Impact of canagliflozin on kidney and cardiovascular outcomes by type 2 diabetes duration: A pooled analysis of the CANVAS Program and CREDENCE Trials. Diabetes Care 2024; 47(3): 501–507. Dostupné z DOI: <http://dx.doi.org/10.2337/dc23–1450>.
Wheeler DC, Stefánsson BV, Jongs N et al. [DAPA-CKD Trial Committees and Investigators]. Effects of dapagliflozin on major adverse kidney and cardiovascular events in patients with diabetic and non-diabetic chronic kidney disease: a prespecified analysis from the DAPA-CKD trial. Lancet Diabetes Endocrinol 2021; 9(1): 22–31. Dostupné z DOI: <http://dx.doi.org/10.1016/S2213–8587(20)30369–7>.
Herrington WG, Staplin N, Wanner C et al. [EMPA-KIDNEY Collaborative Group]. Empagliflozin in patients with chronic kidney disease. N Engl J Med 2022; 388(2): 117–127. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa2204233>.
Li CX, Liu LY, Zhang CX et al. Comparative safety of different sodium-glucose transporter 2 inhibitors in patients with type 2 diabetes: a systematic review and network meta-analysis of randomized controlled trials. Front Endocrinol (Lausanne) 2023; 14: 1238399. Dostupné z DOI: <http://dx.doi.org/10.3389/fendo.2023.1238399>.
Janssen Research & Development LLC. (Posted 2016). Sodium-glucose Co-transporter 2 (SGLT2) Inhibitor Risk of Below-Knee Lower Extremity Amputation: A Retrospective Cohort Study Using a Large Claims Database in the United States (NCT02857764). Dostupné z WWW: <https://clinicaltrials.gov/ct2/show/study/NCT02857764>.
Yi TW, Wong MMY, Neuen BL et al. Effects of canagliflozin on cardiovascular and kidney events in patients with chronic kidney disease with and without peripheral arterial disease: Integrated analysis from the CANVAS Program and CREDENCE trial. Diabetes Obes Metab 2023; 25(7): 2043–2047. Dostupné z DOI: <http://dx.doi.org/10.1111/dom.15065>.
Štítky
Diabetology Endocrinology Internal medicineČlánok vyšiel v časopise
Forum Diabetologicum
2024 Číslo 3
Najčítanejšie v tomto čísle
- 2024: hypoglycaemia in focus
- Modern technologies in the prevention of hypoglycaemia
- Hypoglycemia in patients on hemodialysis with diabetes mellitus
- Non-diabetic forms of hypoglycemia in the pediatric population