Evaluation of the pharmacokinetics, pharmacodynamics and clinical efficacy of empagliflozin for the treatment of type 2 diabetes.
Sodium-glucose co-transporter 2 (SGLT2) inhibitors are the latest class of drugs to be introduced for the treatment of type 2 diabetes mellitus. These drugs improve glycemic control by increasing urinary glucose excretion and exert additional benefits of weight loss and blood pressure reductions. Areas covered: This review outlines the background to SGLT2 inhibitors and provides details on the pharmacokinetics, pharmacodynamics and clinical efficacy of empagliflozin and discusses the cardiovascular outcome trial. Expert opinion: Empagliflozin was the first from a new group of antidiabetic drugs to show benefits in a cardiovascular outcome trial. There were significant reductions in cardiovascular and all-cause mortality and empagliflozin treatment reduced hospitalizations for heart failure and reduced the progression of diabetic nephropathy. These benefits, which occurred at a very early stage during the study, may be related to a reduction in circulating volume or changes in metabolic fuel utilization in the heart and kidneys. Whether these effects are shared by other SGLT2 inhibitors is not yet known, but there may be differences between drugs related to selectivity for inhibition of SGLT2 compared to SGLT1 or other pharmacological effects. Currently the outcome evidence is only available to support the use of empagliflozin in this drug class.
a Research Center for Translational Medicine , Shanghai East Hospital, Tongji University School of Medicine , Shanghai , China.|b Department of Medicine & Therapeutics , The Chinese University of Hong Kong , Shatin , Hong Kong.
Brian
B
Tomlinson
b Department of Medicine & Therapeutics , The Chinese University of Hong Kong , Shatin , Hong Kong.
Miao
M
Hu
a Research Center for Translational Medicine , Shanghai East Hospital, Tongji University School of Medicine , Shanghai , China.
Yuzhen
Y
Zhang
c Division of Cardiology, Department of Internal Medicine, Wan Fang Hospital , Taipei Medical University , Taipei City , Taiwan.
Paul
P
Chan
d Department of Cardiac Surgery, Shanghai East Hospital , Tongji University , Shanghai , China.
Zhong-Min
ZM
Liu
D001559:Benzhydryl Compounds / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D001794:Blood Pressure / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000473:pathology; D005947:Glucose / Q000378:metabolism; D005960:Glucosides / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000494:pharmacology; D000077203:Sodium-Glucose Transporter 2 Inhibitors
D001559:Benzhydryl Compounds; D005960:Glucosides; D007004:Hypoglycemic Agents; D000077203:Sodium-Glucose Transporter 2 Inhibitors; C570240:empagliflozin; D005947:Glucose
Empagliflozin; SGLT2; sodium-glucose co-transporter 2 inhibitors; type 2 diabetes mellitus; urinary glucose excretion