Generic placeholder image

Current Drug Safety

Editor-in-Chief

ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Review Article

Safety of SGLT2 Inhibitors in Patients with Diabetes Mellitus

Author(s): Mahakpreet Singh, Ruchika Sharma and Anoop Kumar*

Volume 14, Issue 2, 2019

Page: [87 - 93] Pages: 7

DOI: 10.2174/1574886314666190206164647

Price: $65

Abstract

Background: Recently, Food and Drug Administration (FDA) has approved sodium/ glucose co-transporter 2 (SGLT2) inhibitors for the treatment of diabetes mellitus. However, regarding adverse drug reactions (ADRs) of SGLT2 inhibitors in large group of population, very less information is available. Thus, we have tried to find out the risk profile of SGLT2 inhibitors.

Materials and Methods: A total of 1,042 studies have been published from Nov. 2012-Nov. 2017 regarding SGLT2 inhibitors. After inclusion and exclusion criteria, 27 studies have been selected for the analysis of risk.

Results and Discussion: The emerging evidence indicates various adverse drug reactions such as foot and toe amputation, cancer, diabetic ketoacidosis, bone fracture risk and urinary as well as mycotic genital infection. The causality assessment has shown a correlation between SGLT2 inhibitors and diabetic ketoacidosis and urinary tract infection.

Conclusion: In conclusion, Marketing Authorization Holder (MAH) and Regulatory Authorities (RA) should monitor various adverse drug reactions such as diabetic ketoacidosis and urinary tract infection with the use of SGLT2 inhibitor.

Keywords: SGLT2 inhibitors, risks, diabetes mellitus, ADRs, metabolic disorders, anti-diabetic drugs.

« Previous
Graphical Abstract
[1]
Garg A, Kumar A. Risk and benefit profile of dulaglutide in established therapeutic indication. Curr Drug Saf 2018; 13(3): 165-70.
[2]
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2014; 37(Suppl. 1): S81-90.
[3]
American Diabetes Association. Standards of medical care in diabetes-2016 abridged for primary care providers. Clin Diabetes 2016; 34: 3.
[4]
Holt RI, Cockram C, Flyvbjerg A, Goldstein BJ, Eds. Textbook of diabetes. John Wiley & Sons USA 2017.
[5]
Bennett WL, Maruthur NM, Singh S, et al. Comparative effectiveness and safety of medications for type 2 diabetes: An update including new drugs and 2-drug combinations. Ann Intern Med 2011; 154: 602-13.
[6]
Singh M, Kumar A. Risks associated with SGLT2 inhibitors: An overview. Curr Drug Saf 2018; 13: 84-91.
[7]
Neumiller JJ, White JR, Campbell RK. Progress and therapeutic potential in type 2 diabetes mellitus. Drugs 2010; 70: 377-85.
[8]
Electronic Medicines Compendium (eMC). Available from:. https://www.medicines.org.uk/emc/search?q=canagliflozin (accessed on 20 sept, 2017)
[9]
FDA approved drug products. Drugs@FDA. Available from:. http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.DrugDetails Accessed 17-Oct, 2017
[11]
Therapeutics Goods Administration. Avaialble from www.tga.govhttps://search.tga.gov.au/s/search.html?collection=tga-websites-web&query=sglt2+inhibitors&op=Search (Accessed on 23 Oct., 2017)
[12]
[13]
Clinical Trials Study- India. Available from:. www.ctri.nic.inhttp://ctri.nic.in/Clinicaltrials/advsearch.php (Accessed on 23 Oct. 2017).
[14]
Electronic Medicines Compendium (eMC) Available from:. www.medicines.org.uk/emc https://www.medicines.org.uk/emc/search?q=dapagliflozin (accessed on 20 Oct., 2017).
[15]
Crespo L, McConnell B, Wick JY. Euglycemic diabetic ketoacidosis: Hidden in plain sight. Consult Pharm 2016; 31: 426-34.
[16]
Bader N, Mirza L. Euglycemic Diabetic Ketoacidosis in a 27 year-old female patient with type-1-Diabetes treated with sodium-glucose cotransporter-2 (SGLT2) inhibitor Canagliflozin. Pak J Med Sci 2016; 32: 786-9.
[17]
Peters AL, Buschur EO, Buse JB, Cohan P, Diner JC, Hirsch IB. Euglycemic diabetic ketoacidosis: A potential complication of treatment with sodium-glucose cotransporter 2 inhibition. Diabetes Care 2015; 38: 1687-93.
[18]
Hayami T, Kato Y, Kamiya H, et al. Case of ketoacidosis by a sodium-glucose cotransporter 2 inhibitor in a diabetic patient with a low-carbohydrate diet. J Diabetes Investig 2015; 6: 587-90.
[19]
Storgaard H, Bagger JI. Knop FK1, Vilsboll T, Rungby J. Diabetic Ketoacidosis in a patient with type 2 diabetes after initiation of sodium-glucose cotransporter 2 inhibitor treatment. Basic Clin Pharmacol Toxicol 2016; 118: 168-70.
[20]
Blau JE, Tella SH, Taylor SI, Rother KI. Ketoacidosis and SGLT2 inhibitor treatment: Analysis of FAERS data. Diabetes Metab Res Rev 2017; 33(8): 1-7.
[21]
Wolverton D, Blair MM. Fracture risk associated with common medications used in treating type 2 diabetes mellitus. Am J Health Syst Pharm 2017; 74(15): 1143-51.
[22]
Blevins TC, Farooki A. Bone effects of canagliflozin, a sodium glucose co-transporter 2 inhibitor, in patients with type 2 diabetes mellitus. Postgrad Med 2017; 129: 159-68.
[23]
Egger A, Kraenzlin ME, Meier C. Effects of incretin-based therapies and SGLT2 inhibitors on skeletal health. Curr Osteoporos Rep 2016; 14: 345-50.
[24]
Alba M, Xie J, Fung A, Desai M. The effects of canagliflozin, a sodium glucose co-transporter 2 inhibitor, on mineral metabolism and bone in patients with type 2 diabetes mellitus. Curr Med Res Opin 2016; 32: 1375-85.
[25]
Johnsson KM, Ptaszynska A, Schmitz B, Sugg J, Parikh SJ, List JF. Urinary tract infections in patients with diabetes treated with dapagliflozin. J Diabetes Complications 2017; 27: 473-8.
[26]
Nicolle LE, Capuano G, Fung A, Usiskin K. Urinary tract infection in randomized phase III studies of canagliflozin, a sodium glucose co-transporter 2 inhibitor. Postgrad Med 2014; 126: 7-17.
[27]
Geerlings S, Fonseca V, Castro-Diaz D, List J, Parikh S. Genital and urinary tract infections in diabetes: Impact of pharmacologically-induced glucosuria. Diabetes Res Clin Pract 2014; 103: 373-81.
[28]
Schneeberger C, Kazemier BM, Geerlings SE. Asymptomatic bacteriuria and urinary tract infections in special patient groups: Women with diabetes mellitus and pregnant women. Curr Opin Infect Dis 2014; 27: 108-14.
[29]
Rizzi M, Trevisan R. Genitourinary infections in diabetic patients in the new era of diabetes therapy with sodium-glucose cotransporter-2 inhibitors. Nutr Metab Cardiovasc Dis 2016; 26: 963-70.
[30]
Hall V, Kwong J, Johnson D, Ekinci EI. Caution advised with dapagliflozin in the setting of male urinary tract outlet obstruction. BMJ Case Rep 2017; 2017 bcr-2017-219335.
[31]
Thong KY, Yadagiri M, Barnes DJ, et al. Clinical risk factors predicting genital fungal infections with sodium-glucose cotransporter 2 inhibitor treatment: The ABCD nationwide dapagliflozin audit. Prim Care Diabetes 2018; 12(1): 45-50.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy