Canagliflozin: A Review in Type 2 Diabetes

Abstract

Canagliflozin (Invokana ® ) is a sodium-glucose co-transporter-2 (SGLT2) inhibitor indicated in various countries worldwide for the once-daily oral treatment of type 2 diabetes (T2D). Unlike many T2D therapies, canagliflozin lowers blood glucose levels independently of insulin, with the inhibition of SGLT2 reducing renal reabsorption of glucose and increasing excretion of glucose in the urine. In well-designed clinical trials, canagliflozin (as first-line monotherapy or add-on therapy to other antihyperglycaemic agents) improved glycaemic control in adults with T2D, including those of older age and/or at high cardiovascular (CV) risk, and also had beneficial effects on their bodyweight and BP; whether the drug impacts the CV risk profile of T2D is currently being evaluated in the large CV outcomes study CANVAS. Canagliflozin was generally well tolerated, had a low risk of hypoglycaemia and was most commonly associated with adverse events such as genital and urinary tract infections and increased urination, consistent with its mechanism of action. Thus, canagliflozin is a useful monotherapy and add-on therapy option for the management of T2D in adults, and its CV profile is eagerly awaited.

Diabetic foot syndrome in patients with diabetes. A multicenter German/Austrian DPV analysis on 33 870 patients

“…A recently conducted meta‐analysis identified hypertension, ischemic heart disease, cerebrovascular disease, and PVD as predisposing factors for higher major amputation rates in subjects with diabetes . Results of the CANVAS‐R study further reported a 2‐fold higher amputation risk in T2D subjects with canagliflozin compared with patients with a placebo . A review from Armstrong et al revealed that in 20% of diabetes patients with moderate or severe diabetic foot infections an amputation was required .…”

Place des inhibiteurs des SGLT2 dans le traitement du patient diabétique de type 2

“…Cette complication n'a pas été rapportée avec l'empagliflozine dans EMPA-REG OUTCOME [11], ni avec la dapagliflozine dans les essais cliniques de phase 2-3 ou dans les études observationnelles [54]. Aucune explication formelle ne peut être fournie actuellement pour expliquer la survenue de cette complication avec la canagliflozine, ni les apparentes différences avec les molécules de la même classe thérapeutique [55]. Par ailleurs, une étude observationnelle en vie réelle n'a pas confirmé un risque accru d'amputations chez les patients traités par la canagliflozine [56].…”

Synthesis and Antiproliferative Activities of Novel Substituted 5‐Anilino‐α‐Glucofuranose Derivatives

“…Dapagliflozin and canagliflozin ( Figure ) are sodium‐dependent glucose transporters 2 (SGLT2) inhibitors, and they are used to treatment of diabetes . Recently, a new potential role for dapagliflozin and canagliflozin as an anti‐cancer agent was reported.…”