title: Canagliflozin - something new for type 2 diabetes, but is it safe and efficacious?
abstract: BACKGROUND
  Inhibition of the sodium-glucose cotransporter 2 (SGLT2), to promote the excretion of glucose, is a new paradigm in the treatment of type 2 diabetes.
  
  
  METHODS
  Canagliflozin is an SGLT2 inhibitor, which has been the subject of two recent clinical trials, which are evaluated.
  
  
  CONCLUSIONS
  Studies with canagliflozin, in subjects with type 2 diabetes, have shown that its use is associated with reductions in HbA1c and body weight and small reductions in blood pressure and triglycerides, while increasing high-density lipoprotein cholesterol and low-density lipoprotein cholesterol. As monotherapy in Japanese subjects, or in comparison with glimepiride in CANTATA-SU (CANagliflozin Treatment and Trial Analysis versus SUlphonylurea), canagliflozin causes a low incidence of hypoglycemia, and this is an advantage over glimepiride. However, one of the disadvantages with canagliflozin, which was also highlighted in CANTATA-SU, is that canagliflozin can cause urogenital infections, which are not observed with other antidiabetic drugs. The Federal Drug Administration has recently approved canagliflozin for use in type 2 diabetes, while directing that a clinical outcome safety trial be undertaken. We are concerned that canagliflozin has been approved for use in type 2 diabetes prior to a clinical outcome study of efficacy being undertaken and without the outcome of further safety testing.
authors.affiliation: Queensland University of Technology, School of Biomedical Sciences, Faculty of Health , GPO 2434, QLD 4002, Brisbane , Australia +61 7 3138 2015 ; +61 7 3138 1534 ; sheila.doggrell@qut.edu.au.
authors.forename: Sheila A
authors.initials: SA
authors.lastname: Doggrell
authors.forename: Kerry
authors.initials: K
authors.lastname: McIntyre
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D005960:Glucosides / Q000008:administration & dosage*; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D013453:Sulfonylurea Compounds / Q000008:administration & dosage*; D013876:Thiophenes / Q000008:administration & dosage*
chemical_list: D005960:Glucosides; D007004:Hypoglycemic Agents; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D013453:Sulfonylurea Compounds; D013876:Thiophenes