title: Effects of Ipragliflozin on Diabetic Nephropathy and Blood Pressure in Patients With Type 2 Diabetes: An Open-Label Study.
abstract: BACKGROUND
  Sodium-glucose cotransporter 2 (SGLT2) inhibitors are novel agents used to treat type 2 diabetic patients. We investigated the efficacy of the SGLT2 inhibitor ipragliflozin on diabetic nephropathy in Japanese patients with type 2 diabetes.
  
  
  METHODS
  A 50 mg dose of ipragliflozin was administered for 24 weeks to 50 patients with type 2 diabetes who were concomitantly managed with diet and exercise therapy alone or antidiabetic medications other than SGLT2 inhibitors.
  
  
  RESULTS
  At the end of the 24-week ipragliflozin treatment, significant decreases in mean glycated hemoglobin (HbA1c) (1.0±1.2%) and body weight (2.7 ± 2.5 kg) were observed; in addition, median urinary albumin-to-creatinine ratio (UACR) significantly decreased from 15.5 (8.0 - 85.7) to 12.9 (7.4 - 36.3) mg/gCr. Sub-analysis by renal function at baseline revealed that median UACR in patients with estimated glomerular filtration rate (eGFR) ≥ 90 mL/min/1.73 m2decreased significantly from 12.3 (7.5 - 89.6) to 10.6 (5.8 - 27.3) mg/gCr. Furthermore, mean eGFR decreased significantly from 102.4 ± 8.6 to 93.6 ± 10.5 mL/min/1.73 m2in these patients. In contrast, UACR and eGFR did not change significantly in patients with eGFR < 90. In addition, analysis of the relationship between the amount of change in UACR and blood pressure at 24 weeks revealed a significant positive correlation between UACR and SBP values, independently of the presence of diabetic nephropathy.
  
  
  CONCLUSIONS
  Our results indicate that ipragliflozin may facilitate HbA1c control and body weight reduction. Furthermore, our results also raise the possibility that ipragliflozin significantly reduces urinary albumin levels and improves glomerular hyperfiltration in a subset of patients with type 2 diabetes.
authors.affiliation: Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan; Department of Internal Medicine, Ogawa Red Cross Hospital, Saitama, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ito
authors.affiliation: Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Ikuma-Suwa
authors.affiliation: Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan; Department of Internal Medicine, Ogawa Red Cross Hospital, Saitama, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Inoue
authors.affiliation: Department of Nursing, Ogawa Red Cross Hospital, Saitama, Japan.
authors.forename: Kimie
authors.initials: K
authors.lastname: Kaneko
authors.affiliation: Department of Internal Medicine, Ogawa Red Cross Hospital, Saitama, Japan; Satsuki Medical Clinic, Saitama, Japan.
authors.forename: Morifumi
authors.initials: M
authors.lastname: Yanagisawa
authors.affiliation: Department of Diabetes and Endocrinology, Higashiyamato Hospital, Tokyo, Japan.
authors.forename: Kouichi
authors.initials: K
authors.lastname: Inukai
authors.affiliation: Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Noda
authors.affiliation: Department of Endocrinology and Diabetes, Saitama Medical University, Saitama, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Shimada
keywords: Blood pressure; Diabetic nephropathy; Ipragliflozin; Sodium-glucose cotransporter 2 inhibitor; Type 2 diabetes