Cardiometabolic Effects of a New Class of Antidiabetic Agents

Desouza, Cyrus; Gupta, Namita; Patel, Anery

doi:10.1016/j.clinthera.2015.02.016

Cited by 42 publications

(35 citation statements)

References 93 publications

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“…A small number of studies have reported beneficial effects of SGLT2 inhibitors on lipid parameters, including reductions in triglyceride levels and small increases in high-density lipoprotein cholesterol (HDL-C) levels [14, 33, 34] (Fig. 1).…”

Section: Effects On Lipid Profilesmentioning

confidence: 99%

Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors and Cardiovascular Disease: A Systematic Review

Kalra

2016

Cardiol Ther

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Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a novel class of drugs that have been extensively investigated for the treatment of hyperglycemia in type 2 diabetes mellitus (T2DM). These drugs reduce hyperglycemia by blocking renal glucose reabsorption, thereby promoting increased renal glucose excretion. Beyond glycemic control, these drugs have other beneficial effects on cardiovascular (CV) risk factors. The present review discusses the potential role of SGLT2 inhibitors in treating CV complications (acute and chronic) associated with T2DM. Funding: AstraZeneca Pharma India Ltd.

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Section: Effects On Lipid Profilesmentioning

confidence: 99%

Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors and Cardiovascular Disease: A Systematic Review

Kalra

2016

Cardiol Ther

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“…However, cases of serious hypersensitivity reactions, including Stevens-Johnson syndrome, as well as angioedema, urticaria, bronchial hyperreactivity, and other immune-mediated dermatological effects have been reported rarely with DPP-4 inhibitors (26). Common side effects of GLP-1 receptor agonists are nausea and vomiting, and hypoglycemia has been reported in clinical studies of these agents, especially when used in combination with sulfonylureas or insulin (59). For many patients, the benefits of GLP-1 receptor agonists outweigh the risks, given their favorable effects on body weight, blood pressure, and lipids (59).…”

Section: Considerations For Use Of Canagliflozin and Incretin-based Tmentioning

confidence: 99%

“…Common side effects of GLP-1 receptor agonists are nausea and vomiting, and hypoglycemia has been reported in clinical studies of these agents, especially when used in combination with sulfonylureas or insulin (59). For many patients, the benefits of GLP-1 receptor agonists outweigh the risks, given their favorable effects on body weight, blood pressure, and lipids (59). Pancreatitis may be a concern with incretin-based therapies, although reported events with GLP-1 receptor agonists and DPP-4 inhibitors have been rare.…”

Section: Considerations For Use Of Canagliflozin and Incretin-based Tmentioning

confidence: 99%

Use of Canagliflozin in Combination With and Compared to Incretin-Based Therapies in Type 2 Diabetes

Pratley

Cersósimo

2017

Clinical Diabetes

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In Brief Sodium–glucose cotransporter 2 (SGLT2) inhibitors and incretin-based therapies (dipeptidyl peptidase-4 [DPP-4] inhibitors and glucagon-like peptide-1 [GLP-1] receptor agonists) are widely used to treat patients with type 2 diabetes. In clinical and real-world studies, canagliflozin, an SGLT2 inhibitor, has demonstrated superior A1C lowering compared to the DPP-4 inhibitor sitagliptin. Canagliflozin can also promote modest weight/fat loss and blood pressure reduction. The addition of canagliflozin to treatment regimens that include a DPP-4 inhibitor or a GLP-1 receptor agonist has been shown to further improve glycemic control, while still maintaining beneficial effects on cardiometabolic parameters such as body weight and blood pressure. Overall, the available clinical and real-world evidence suggests that canagliflozin is a safe and well-tolerated treatment option that can be considered either in addition to or instead of incretin-based therapies for patients with type 2 diabetes.

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“…Trials for exenatide (EXSCEL), dulaglutide (REWIND), liraglutide (LEADER), and semaglutide (SUSTAIN 6) will provide further understanding of cardiovascular outcomes of chronic GLP-1 receptor agonist therapy [134] (Table 2). …”

Section: Cardiovascular Effects Of Anti-diabetes Medications By Drmentioning

confidence: 99%

“…Forthcoming studies are being conducted for canagliflozin (CANVAS, CANVAS-R, CREDENCE), dapagliflozin (DECLARE-TIMI 58), and ertugliflozin [134] (Table 2). In meta-analyses of cardiovascular events for canagliflozin and/or dapagliflozin treatment, there was no increase in risk for the composite endpoint of cardiovascular death, MI, and stroke [141–143].…”

Section: Cardiovascular Effects Of Anti-diabetes Medications By Drmentioning

confidence: 99%

Cardiovascular effects of anti-diabetes drugs

Younk

Lamos

2016

Expert Opinion on Drug Safety

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Introduction Cardiovascular disease remains the major contributor to morbidity and mortality in diabetes. From the need to reduce cardiovascular risk in diabetes and to ensure that such risk is not exacerbated by drug treatments, governmental regulators and drug manufacturers have focused on clinical trials evaluating cardiovascular outcomes. Areas covered Findings from mechanistic and clinical trials of biguanides, sulfonylureas, thiazolidinediones, dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and sodium-glucose transporter 2 (SGLT-2) inhibitors will be reviewed. These drug classes will be compared within the context of available cardiovascular outcomes data. Clinical implications of new study regulations will be examined. Expert opinion Recent cardiovascular studies provide a more comprehensive evaluation of specific anti-diabetes therapy in individuals with high cardiovascular risk. Long-term effects of anti-hyperglycemic agents in patients with lower cardiovascular risk are still speculative. Historical data supports continued use of metformin as a first-line agent. DPP-4 inhibitors and GLP-1 receptor agonists appear to have neutral effects on cardiovascular outcomes. The significantly decreased cardiovascular risk associated with empagliflozin SGLT-2 inhibitor therapy is impressive and may change how practitioners prescribe add-on therapy to metformin.

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Cardiometabolic Effects of a New Class of Antidiabetic Agents

Cited by 42 publications

References 93 publications

Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors and Cardiovascular Disease: A Systematic Review

Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitors and Cardiovascular Disease: A Systematic Review

Use of Canagliflozin in Combination With and Compared to Incretin-Based Therapies in Type 2 Diabetes

Cardiovascular effects of anti-diabetes drugs

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