SGLT2 inhibitors in the pipeline for the treatment of diabetes mellitus in Japan.
BACKGROUND
Sodium glucose cotransporter 2 (SGLT2) inhibitors have been available for the treatment of type 2 diabetes (T2DM) in Japan since April 2014. The prescription rate in Japan is low in comparison to Western countries. We summarize the results obtained from the phase 3 clinical trials and clinical studies involving Japanese T2DM patients. We also discuss the current situation and the future prospects of SGLT2 inhibitors in Japan.


METHODS
Unexpected adverse events, such as cerebral infarction and diabetic ketoacidosis have been reported from clinics shortly after the initiation of SGLT2 inhibitor treatment. However, the reductions in blood glucose levels and body weight have been demonstrated in phase 3 trials using 6 types of SGLT2 inhibitors, while observational studies of Japanese T2DM patients, which were performed in the clinical setting, showed that the incidence of adverse drug reactions, such as severe hypoglycemia, was low.


CONCLUSIONS
SGLT2 inhibitors are also considered to be effective for treating Japanese patients with T2DM. When prescribing SGLT2 inhibitors, it is necessary to ensure that they are used appropriately because the Japanese T2DM patient population has a high proportion of elderly individuals and a high incidence of cerebrovascular disease.
a Department of Diabetes, Metabolism and Kidney Disease , Edogawa Hospital , Tokyo , Japan.
Hiroyuki
H
Ito
a Department of Diabetes, Metabolism and Kidney Disease , Edogawa Hospital , Tokyo , Japan.
Masahiro
M
Shinozaki
a Department of Diabetes, Metabolism and Kidney Disease , Edogawa Hospital , Tokyo , Japan.
Shinya
S
Nishio
a Department of Diabetes, Metabolism and Kidney Disease , Edogawa Hospital , Tokyo , Japan.
Mariko
M
Abe
D001835:Body Weight; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D007564:Japan; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors
D007004:Hypoglycemic Agents; C089180:SLC5A2 protein, human; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors
Japanese; Sodium glucose cotransporter 2 inhibitors; canagliflozin; dapagliflozin; empagliflozin; ipragliflozin; luseogliflozin; obesity; tofogliflozin; weight reduction