New SGLT2 inhibitor shows promise as diabetes treatment

the Clinical Advisor take:

The investigational sodium-dependent glucose transporter 2 (SGLT2 inhibitor) remogliflozin etabonate significantly improved glucose control in patients with type 2 diabetes, according to a report published in MedPage Today.

Lead researcher William O. Wilkison, PhD, of Islet Sciences, and colleagues found that remogliflozin significantly lowered HbA1c levels compared to a placebo after 12 weeks.

"Inhibition of [SGLT2] offers a new approach for the treatment of type 2 diabetes through increased renal glucose excretion, which results in decreased blood glucose and weight loss," wrote Wilkison and colleagues.

The researchers randomized participants to receive placebo or remogliflozin in doses of 100, 250, 500, or 1,000 mg once daily, 250 mg twice daily, or 30 mg of pioglitazone once daily for three months.

The researchers saw a significant change in HbA1c at 12 weeks with remogliflozin compared with placebo for the 1,000 mg per day group, at -0.66% (95% CI minus 1.05-minus 0.28, P=0.001); 250 mg twice daily, at -0.59% (95% CI minus 0.97-minus 0.20, P=0.003); and 250 mg per day, at -0.56% (95% CI minus 0.95 to-minus 0.16, P=0.006). They also saw weight loss in all the remogliflozin groups except 100 mg once daily, with losses ranging from 1.44 to 1.51 kg at three months.

In the remogliflozin groups, the only adverse events that occurred in more than 10% of patients were dizziness and urinary tract infections. The overall rates of adverse effects in the remogliflozin groups were 31% to 59%, and were 34% and 22% in the pioglitazone and placebo groups, respectively.