SGLT-2 inhibitors: diabetes treatment by glycosuria; literature review on the effect of dapagliflozin

• Published in: Nederlands tijdschrift voor geneeskunde Vol. 157; no. 38; p. A5969
• Main Authors: Kleefstra, Nanne, Drion, Iefke, van Hateren, K J J Hans, Holleman, Frits, Goudswaard, A N Lex, Bilo, Henk J G
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 2013
• Subjects: Benzhydryl Compounds; Blood Glucose - drug effects; Blood Glucose - metabolism; Body Weight - drug effects; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Glucosides - therapeutic use; Glycated Hemoglobin A - analysis; Glycated Hemoglobin A - metabolism; Humans; Hypoglycemic Agents - therapeutic use; Metformin - adverse effects; Metformin - antagonists & inhibitors; Metformin - therapeutic use; Netherlands; Sodium-Glucose Transporter 2 Inhibitors; Treatment Outcome; Weight Loss; Netherlands
• ISSN: 0028-2162; 1876-8784

To describe the efficacy and safety of dapagliflozin, the first sodium-glucose co-transporter-2 (SGLT-2) inhibitor for the treatment of diabetes mellitus type 2 (DM2) to be registered in the Netherlands. Literature review. We searched the Medline database for articles on the use of dapagliflozin in patients with DM2. We included randomised studies with a minimum duration of 12 weeks and systematic reviews published up to 19 October 2012. Two assessors selected the articles on the basis of title, abstract and if necessary, the complete text. Eleven articles were suitable for analysis. On comparison with placebo, the use of dapagliflozin gave a drop in HbA1c-value of approximately 0.5-0.8 percentage points (6-9 mmol/mol). The body weight of patients who used dapagliflozin dropped between 1.0-2.4 kg on comparison with the placebo and metformin control groups. Urinary tract infections occurred twice as often and genital infections three to four times more often. There were no data on the effect on micro- and macrovascular complications or on mortality. Dapagliflozin regulates the blood glucose levels less effectively than currently used medications, although the small number of studies that compare dapagliflozin with metformin or glipizide show no differences in the drop in HbA1c between the study groups. Dapagliflozin use leads to minor, clinically non-relevant weight loss. There are as yet no data on its long term efficacy and safety.