title: Dapagliflozin--do we need it registered for type 2 diabetes?
abstract: BACKGROUND
  Inhibitors of the sodium-glucose co-transporter 2 (SGLT2) promote the excretion of glucose to reduce glycated hemoglobin (HbA1c) levels. Canagliflozin was the first SGLT2 inhibitor to be approved by the US FDA for use in the treatment of type 2 diabetes, and recently dapagliflozin has also been approved.
  
  
  METHODS
  We evaluated a recent Phase III clinical trial with dapagliflozin.
  
  
  CONCLUSIONS
  Dapagliflozin was studied as add-on therapy to sitagliptin with or without metformin, and was shown to lower HbA1c levels and body weight. The incidence of hypoglycaemia was low with dapagliflozin, but it did increase the incidence of urogenital infections. As no clear benefits have been identified for dapagliflozin over canagliflozin, which was the first gliflozin registered by the FDA, we do not fully understand why it was necessary to register dapagliflozin. Given that there are no completed cardiovascular/clinical outcome studies with dapagliflozin, and therefore no evidence of beneficial effect, it also seems premature to be using it extensively or considering it as an alternative to the clinically proven metformin.
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: Rinku
authors.initials: R
authors.lastname: Tuli
mesh_terms: D001559:Benzhydryl Compounds / Q000008:administration & dosage*; 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; D008687:Metformin / Q000008:administration & dosage*; D011719:Pyrazines / Q000008:administration & dosage*; D014230:Triazoles / Q000008:administration & dosage*
chemical_list: D001559:Benzhydryl Compounds; D005960:Glucosides; D007004:Hypoglycemic Agents; D011719:Pyrazines; D014230:Triazoles; D008687:Metformin
keywords: HbA1c; dapagliflozin; metformin; sitagliptin; sodium glucose co-transporter 2 inhibitors; type 2 diabetes