Sodium-Dependent Glucose Cotransporters
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Katakami et al. Cardiovasc Diabetol (2020) 19:110 https://doi.org/10.1186/s12933-020-01079-4 Cardiovascular Diabetology ORIGINAL INVESTIGATION Open Access Tofoglifozin does not delay progression of carotid atherosclerosis in patients with type 2 diabetes: a prospective, randomized, open-label, parallel-group comparative study Naoto Katakami1,2* , Tomoya Mita3, Hidenori Yoshii4, Toshihiko Shiraiwa5, Tetsuyuki Yasuda6, Yosuke Okada7, Keiichi Torimoto7, Yutaka Umayahara8, Hideaki Kaneto9, Takeshi Osonoi10, Tsunehiko Yamamoto11, Nobuichi Kuribayashi12, Kazuhisa Maeda13, Hiroki Yokoyama14, Keisuke Kosugi15, Kentaro Ohtoshi16, Isao Hayashi17, Satoru Sumitani18, Mamiko Tsugawa19, Kayoko Ryomoto20, Hideki Taki21, Tadashi Nakamura22, Satoshi Kawashima23, Yasunori Sato24, Hirotaka Watada3 and Iichiro Shimomura1 on behalf of the UTOPIA study investigators Abstract Background: This study aimed to investigate the preventive efects of tofoglifozin, a selective sodium-glucose cotransporter 2 (SGLT2) inhibitor, on atherosclerosis progression in type 2 diabetes (T2DM) patients without apparent cardiovascular disease (CVD) by monitoring carotid intima-media thickness (IMT). Methods: This prospective, randomized, open-label, blinded-endpoint, multicenter, parallel-group, comparative study included 340 subjects with T2DM and no history of apparent CVD recruited at 24 clinical units. Subjects were randomly allocated to either the tofoglifozin treatment group (n 169) or conventional treatment group using drugs other than SGLT2 inhibitors (n 171). Primary outcomes were changes= in mean and maximum common carotid IMT measured by echography during= a 104-week treatment period. Results: In a mixed-efects model for repeated measures, the mean IMT of the common carotid artery (mean- IMT-CCA), along with the right and left maximum IMT of the CCA (max-IMT-CCA), signifcantly declined in both the tofoglifozin ( 0.132 mm, SE 0.007; 0.163 mm, SE 0.013; 0.170 mm, SE 0.020, respectively) and the control group ( 0.140 mm,− SE 0.006; 0.190 mm,− SE 0.012; 0.190 mm,− SE 0.020, respectively). -
Supplementary Material
Supplementary material Table S1. Search strategy performed on the following databases: PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL). 1. Randomi*ed study OR random allocation OR Randomi*ed controlled trial OR Random* Control* trial OR RCT Epidemiological study 2. sodium glucose cotransporter 2 OR sodium glucose cotransporter 2 inhibitor* OR sglt2 inhibitor* OR empagliflozin OR dapagliflozin OR canagliflozin OR ipragliflozin OR tofogliflozin OR ertugliflozin OR sotagliflozin OR sergliflozin OR remogliflozin 3. 1 AND 2 1 Table S2. Safety outcomes of empagliflozin and linagliptin combination therapy compared with empagliflozin or linagliptin monotherapy in treatment naïve type 2 diabetes patients Safety outcome Comparator 1 Comparator 2 I2 RR [95% CI] Number of events Number of events / / total subjects total subjects i. Empagliflozin + linagliptin vs empagliflozin monotherapy Empagliflozin + Empagliflozin linagliptin monotherapy ≥ 1 AE(s) 202/272 203/270 77% 0.99 [0.81, 1.21] ≥ 1 drug-related 37/272 38/270 0% 0.97 [0.64, 1.47] AE(s) ≥ 1 serious AE(s) 13/272 19/270 0% 0.68 [0.34, 1.35] Hypoglycaemia* 0/272 5/270 0% 0.18 [0.02, 1.56] UTI 32/272 25/270 29% 1.28 [0.70, 2.35] Events suggestive 12/272 13/270 9% 0.92 [0.40, 2.09] of genital infection i. Empagliflozin + linagliptin vs linagliptin monotherapy Empagliflozin + Linagliptin linagliptin monotherapy ≥ 1 AE(s) 202/272 97/135 0% 1.03 [0.91, 1.17] ≥ 1 drug-related 37/272 17/135 0% 1.08 [0.63, 1.84] AE(s) ≥ 1 serious AE(s) 13/272 2/135 0% 3.22 [0.74, 14.07] Hypoglycaemia* 0/272 1/135 NA 0.17 [0.01, 4.07] UTI 32/272 12/135 0% 1.32 [0.70, 2.49] Events suggestive 12/272 4/135 0% 1.45 [0.47, 4.47] of genital infection RR, relative risk; AE, adverse event; UTI, urinary tract infection. -
Steglujan, INN-Ertugliflozin-Sitagliptin
25 January 2018 EMA/86941/2018 Committee for Medicinal Products for Human Use (CHMP) Assessment report Steglujan International non-proprietary name: ertugliflozin / sitagliptin Procedure No. EMEA/H/C/004313/0000 Note Assessment report as adopted by the CHMP with all information of a commercially confidential nature deleted. 30 Churchill Place ● Canary Wharf ● London E14 5EU ● United Kingdom Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Send a question via our website www.ema.europa.eu/contact An agency of the European Union © European Medicines Agency, 2018. Reproduction is authorised provided the source is acknowledged. Table of contents 1. Background information on the procedure .............................................. 7 1.1. Submission of the dossier ...................................................................................... 7 1.2. Steps taken for the assessment of the product ......................................................... 8 2. Scientific discussion ................................................................................ 9 2.1. Problem statement ............................................................................................... 9 2.1.1. Disease or condition ........................................................................................... 9 2.1.2. Epidemiology .................................................................................................... 9 2.1.3. Clinical presentation .......................................................................................... -
Role of Apple Phytochemicals, Phloretin and Phloridzin, in Modulating Processes Related to Intestinal Inflammation
nutrients Article Role of Apple Phytochemicals, Phloretin and Phloridzin, in Modulating Processes Related to Intestinal Inflammation Danuta Zielinska 1, José Moisés Laparra-Llopis 2, Henryk Zielinski 3, Dorota Szawara-Nowak 3 and Juan Antonio Giménez-Bastida 3,4,* 1 Department of Chemistry, University of Warmia and Mazury, 10-727 Olsztyn, Poland; [email protected] 2 Group of Molecular Immunonutrition in Cancer, Madrid Institute for Advanced Studies in Food (IMDEA-Food), 28049 Madrid, Spain; [email protected] 3 Institute of Animal Reproduction and Food Research, Department of Chemistry and Biodynamics of Food, Polish Academy of Science, 10-748 Olsztyn, Poland; [email protected] (H.Z.); [email protected] (D.S.-N.) 4 Group on Quality, Safety and Bioactivity of Plant Foods, Centro de Edafología y Biología Aplicada del Segura (CSIC), 30100 Murcia, Spain * Correspondence: [email protected] Received: 25 April 2019; Accepted: 23 May 2019; Published: 25 May 2019 Abstract: Plant-derived food consumption has gained attention as potential intervention for the improvement of intestinal inflammatory diseases. Apple consumption has been shown to be effective at ameliorating intestinal inflammation symptoms. These beneficial effects have been related to (poly)phenols, including phloretin (Phlor) and its glycoside named phloridzin (Phldz). To deepen the modulatory effects of these molecules we studied: i) their influence on the synthesis of proinflammatory molecules (PGE2, IL-8, IL-6, MCP-1, and ICAM-1) in IL-1β-treated myofibroblasts of the colon CCD-18Co cell line, and ii) the inhibitory potential of the formation of advanced glycation end products (AGEs). -
Natural Products As Lead Compounds for Sodium Glucose Cotransporter (SGLT) Inhibitors
Reviews Natural Products as Lead Compounds for Sodium Glucose Cotransporter (SGLT) Inhibitors Author ABSTRACT Wolfgang Blaschek Glucose homeostasis is maintained by antagonistic hormones such as insulin and glucagon as well as by regulation of glu- Affiliation cose absorption, gluconeogenesis, biosynthesis and mobiliza- Formerly: Institute of Pharmacy, Department of Pharmaceu- tion of glycogen, glucose consumption in all tissues and glo- tical Biology, Christian-Albrechts-University of Kiel, Kiel, merular filtration, and reabsorption of glucose in the kidneys. Germany Glucose enters or leaves cells mainly with the help of two membrane integrated transporters belonging either to the Key words family of facilitative glucose transporters (GLUTs) or to the Malus domestica, Rosaceae, Phlorizin, flavonoids, family of sodium glucose cotransporters (SGLTs). The intesti- ‑ SGLT inhibitors, gliflozins, diabetes nal glucose absorption by endothelial cells is managed by SGLT1, the transfer from them to the blood by GLUT2. In the received February 9, 2017 kidney SGLT2 and SGLT1 are responsible for reabsorption of revised March 3, 2017 filtered glucose from the primary urine, and GLUT2 and accepted March 6, 2017 GLUT1 enable the transport of glucose from epithelial cells Bibliography back into the blood stream. DOI http://dx.doi.org/10.1055/s-0043-106050 The flavonoid phlorizin was isolated from the bark of apple Published online April 10, 2017 | Planta Med 2017; 83: 985– trees and shown to cause glucosuria. Phlorizin is an inhibitor 993 © Georg Thieme Verlag KG Stuttgart · New York | of SGLT1 and SGLT2. With phlorizin as lead compound, specif- ISSN 0032‑0943 ic inhibitors of SGLT2 were developed in the last decade and some of them have been approved for treatment mainly of Correspondence type 2 diabetes. -
CDR Clinical Review Report for Soliqua
CADTH COMMON DRUG REVIEW Clinical Review Report Insulin glargine and lixisenatide injection (Soliqua) (Sanofi-Aventis) Indication: adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus inadequately controlled on basal insulin (less than 60 units daily) alone or in combination with metformin. Service Line: CADTH Common Drug Review Version: Final (with redactions) Publication Date: January 2019 Report Length: 118 Pages Disclaimer: The information in this document is intended to help Canadian health care decision-makers, health care professionals, health systems leaders, and policy-makers make well-informed decisions and thereby improve the quality of health care services. While patients and others may access this document, the document is made available for informational purposes only and no representations or warranties are made with respect to its fitness for any particular purpose. The information in this document should not be used as a substitute for professional medical advice or as a substitute for the application of clinical judgment in respect of the care of a particular patient or other professional judgment in any decision-making process. The Canadian Agency for Drugs and Technologies in Health (CADTH) does not endorse any information, drugs, therapies, treatments, products, processes, or services. While care has been taken to ensure that the information prepared by CADTH in this document is accurate, complete, and up-to-date as at the applicable date the material was first published by CADTH, CADTH does not make any guarantees to that effect. CADTH does not guarantee and is not responsible for the quality, currency, propriety, accuracy, or reasonableness of any statements, information, or conclusions contained in any third-party materials used in preparing this document. -
Glucose Cotransporter 2 Inhibitor, Attenuates Body Weight Gain and Fat Accumulation in Diabetic and Obese Animal Models
OPEN Citation: Nutrition & Diabetes (2014) 4, e125; doi:10.1038/nutd.2014.20 & 2014 Macmillan Publishers Limited All rights reserved 2044-4052/14 www.nature.com/nutd ORIGINAL ARTICLE Tofogliflozin, a sodium/glucose cotransporter 2 inhibitor, attenuates body weight gain and fat accumulation in diabetic and obese animal models M Suzuki1, M Takeda1, A Kito1, M Fukazawa1, T Yata2, M Yamamoto1, T Nagata1, T Fukuzawa1, M Yamane1, K Honda1, Y Suzuki1 and Y Kawabe1 OBJECTIVE: Tofogliflozin, a highly selective inhibitor of sodium/glucose cotransporter 2 (SGLT2), induces urinary glucose excretion (UGE), improves hyperglycemia and reduces body weight in patients with Type 2 diabetes (T2D). The mechanisms of tofogliflozin on body weight reduction were investigated in detail with obese and diabetic animal models. METHODS: Diet-induced obese (DIO) rats and KKAy mice (a mouse model of diabetes with obesity) were fed diets containing tofogliflozin. Body weight, body composition, biochemical parameters and metabolic parameters were evaluated. RESULTS: In DIO rats tofogliflozin was administered for 9 weeks, UGE was induced and body weight gain was attenuated. Body fat mass decreased without significant change in bone mass or lean body mass. Food consumption (FC) increased without change in energy expenditure, and deduced total calorie balance (deduced total calorie balance ¼ FC À UGE À energy expenditure) decreased. Respiratory quotient (RQ) and plasma triglyceride (TG) level decreased, and plasma total ketone body (TKB) level increased. Moreover, plasma leptin level, adipocyte cell size and proportion of CD68-positive cells in mesenteric adipose tissue decreased. In KKAy mice, tofogliflozin was administered for 3 or 5 weeks, plasma glucose level and body weight gain decreased together with a reduction in liver weight and TG content without a reduction in body water content. -
Download Product Insert (PDF)
PRODUCT INFORMATION Remogliflozin A Item No. 14340 CAS Registry No.: 329045-45-6 OH Formal Name: 5-methyl-4-[[4-(1-methylethoxy) N O OH phenyl]methyl]-1-(1-methylethyl)- N 1H-pyrazol-3-yl β-D- O glucopyranoside OH Synonym: GSK189074 OH MF: C23H34N2O7 FW: 450.5 Purity: ≥98% λ: 229 nm UV/Vis.: max O Supplied as: A crystalline solid Storage: -20°C Stability: ≥2 years Information represents the product specifications. Batch specific analytical results are provided on each certificate of analysis. Laboratory Procedures Remogliflozin A is supplied as a crystalline solid. A stock solution may be made by dissolving the remogliflozin A in the solvent of choice. Remogliflozin A is soluble in organic solvents such as ethanol, DMSO, and dimethyl formamide, which should be purged with an inert gas. The solubility of remogliflozin A in these solvents is approximately 30 mg/ml. Remogliflozin A is sparingly soluble in aqueous buffers. For maximum solubility in aqueous buffers, remogliflozin A should first be dissolved in ethanol and then diluted with the aqueous buffer of choice. Remogliflozin A has a solubility of approximately 0.5 mg/ml in a 1:1 solution of ethanol:PBS (pH 7.2) using this method. We do not recommend storing the aqueous solution for more than one day. Description Remogliflozin A is a potent inhibitor of sodium-glucose transporter 2 (SGLT2; Kis = 12.4 and 26 nM 1 for human and rat SGLT2, respectively). It is selective for SGLT2 over SGLT1 (Kis = 4,520 and 997 nM for human and rat SGLT1, respectively). Following administration of a prodrug, remogliflozin etabonate, that is rapidly converted to remogliflozin A in vivo, rat urinary glucose excretion increases and plasma glucose and insulin concentrations decrease. -
Steglujan (Ertugliflozin/Sitagliptin), Segluromet
Steglatro™ (ertugliflozin), Steglujan™ (ertugliflozin/sitagliptin), Segluromet™ (ertugliflozin/metformin) – New drug approval • On December 19, 2017, the FDA approved Merck’s Steglatro (ertugliflozin), Steglujan (ertugliflozin/sitagliptin), and Segluromet (ertugliflozin/metformin) as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus (T2DM). — Steglujan is indicated when treatment with both ertugliflozin and sitagliptin is appropriate. — Segluromet is indicated when patients are not adequately controlled on a regimen containing ertugliflozin or metformin, or in patients who are already treated with both ertugliflozin and metformin. — These drugs are not recommended in patients with type 1 diabetes mellitus (T1DM) or for the treatment of diabetic ketoacidosis. — Steglujan has not been studied in patients with a history of pancreatitis. It is unknown whether patients with a history of pancreatitis are at increased risk for the development of pancreatitis while using Steglujan. • Ertugliflozin is the fourth sodium-glucose co-transoporter-2 (SGLT2) inhibitor approved by the FDA. Other marketed SGLT2 inhibitors include Jardiance® (empagliflozin), Farxiga® (dapagliflozin), and Invokana® (canagliflozin). • The efficacy and safety of ertugliflozin were evaluated in multiple clinical studies involving patients with T2DM. Ertugliflozin was studied as monotherapy and in combination with metformin and/or a dipeptidyl peptidase 4 (DPP-4) inhibitor. Ertugliflozin was also studied in combination with other antidiabetic medications, including insulin and a sulfonylurea, and in T2DM patients with moderate renal impairment. — In patients with T2DM, treatment with ertugliflozin, ertugliflozin + sitagliptin, and ertugliflozin + metformin reduced hemoglobin A1c (HbA1c) vs. placebo or the active comparator. — In patients with T2DM and moderate renal impairment, treatment with ertugliflozin did not result in a reduction in HbA1c vs. -
The Na+/Glucose Co-Transporter Inhibitor Canagliflozin Activates AMP-Activated Protein Kinase by Inhibiting Mitochondrial Function and Increasing Cellular AMP Levels
Page 1 of 37 Diabetes Hawley et al Canagliflozin activates AMPK 1 The Na+/glucose co-transporter inhibitor canagliflozin activates AMP-activated protein kinase by inhibiting mitochondrial function and increasing cellular AMP levels Simon A. Hawley1†, Rebecca J. Ford2†, Brennan K. Smith2, Graeme J. Gowans1, Sarah J. Mancini3, Ryan D. Pitt2, Emily A. Day2, Ian P. Salt3, Gregory R. Steinberg2†† and D. Grahame Hardie1†† 1Division of Cell Signalling & Immunology, School of Life Sciences, University of Dundee, Dundee, Scotland, UK 2Division of Endocrinology and Metabolism, Department of Medicine, McMaster University, Hamilton, Ontario, Canada 3Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, Scotland, UK Running title: Canagliflozin activates AMPK Corresponding authors: Dr. D. G. Hardie, Division of Cell Signalling & Immunology, School of Life Sciences, University of Dundee, Dow Street, Dundee, DD1 5EH, Scotland, UK; Dr. G.R. Steinberg, Division of Endocrinology and Metabolism, Department of Medicine, McMaster University, Hamilton, Ontario, Canada Tel: +44 (1382) 384253; FAX: +44 (1382) 385507; e-mail: [email protected] Tel: +1 (905) 525-9140 ext.21691; email: [email protected] Word count in main text: 3,996 Number of Figures: 7 †these authors made equal contributions to this study ††joint corresponding authors Diabetes Publish Ahead of Print, published online July 5, 2016 Diabetes Page 2 of 37 Hawley et al Canagliflozin activates AMPK 2 ABSTRACT Canagliflozin, dapagliflozin and empagliflozin, all recently approved for treatment of Type 2 diabetes, were derived from the natural product phlorizin. They reduce hyperglycemia by inhibiting glucose re- uptake by SGLT2 in the kidney, without affecting intestinal glucose uptake by SGLT1. -
Newer Diabetes Treatments Drug Class Update with New Drug Evaluation: Semaglutide and Ertugliflozin
© Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35 Salem, Oregon 97301-1079 Phone 503-947-5220 | Fax 503-947-1119 Newer Diabetes Treatments Drug Class Update with New Drug Evaluation: Semaglutide and Ertugliflozin Date of Review: July 2018 Date of Last Review: September 2017 End Date of Literature Search: 05/23/2018 Generic Name: semaglutide Brand Name (Manufacturer): Ozempic® (Novo Nordisk) Generic Name: ertugliflozin, ertugliflozin/sitagliptin, ertugliflozin/metformin Brand Name (Manufacturer): Steglatro™, Steglujan™, Segluromet™ (Merck & Co., Inc.) Dossier Received: ertugliflozin (yes), semaglutide (no) Current Status of PDL Class: See Appendix 1. Purpose for Class Update: To evaluate the safety and efficacy of semaglutide and ertugliflozin (and combinations) which were recently approved for blood glucose lowering in patients with type 2 diabetes mellitus (T2DM). High quality new evidence published since the last review will also be presented. Research Questions: 1. In patients with T2DM, is there any new comparative evidence for non-insulin antidiabetic therapies based on surrogate efficacy outcomes (e.g., hemoglobin A1c [HbA1c]) and long-term clinically meaningful effectiveness outcomes (e.g., microvascular outcomes, macrovascular outcomes and mortality)? 2. In patients with T2DM, is there any new comparative evidence for non-insulin diabetes treatments based on harms outcomes (e.g., severe hypoglycemia, heart failure, diabetic ketoacidosis, pancreatitis, etc.)? 3. Are there subpopulations of patients with T2DM for which specific therapies may be more effective or associated with less harm? 4. What are the efficacy and harms evidence for the two new non-insulin diabetes treatments, ertugliflozin and semaglutide? Conclusions: A Drug Effectiveness Review Project (DERP) update on newer diabetes therapies, three new guidelines/standards, one new randomized controlled trial and two new drug reviews were reviewed for this class update. -
Remogliflozin Etabonate, a Selective Inhibitor of the Sodium-Glucose
Clinical Care/Education/Nutrition/Psychosocial Research BRIEF REPORT Remogliflozin Etabonate, a Selective Inhibitor of the Sodium-Glucose Transporter 2, Improves Serum Glucose Profiles in Type 1 Diabetes 1,2 3 SUNDER MUDALIAR, MD JUNE YE, PHD placebo (placebo), 2) mealtime insulin 1 3 DEBRA A. ARMSTRONG, BA, RN, CCRC ELIZABETH K. HUSSEY, PHARMD 2 3 injection + RE placebo (prandial insulin), ANNIE A. MAVIAN, MD DEREK J. NUNEZ, MD 3 3 1,2 ) placebo insulin injection + 50 mg RE (RE ROBIN O’CONNOR-SEMMES, PHD ROBERT R. HENRY, MD 3 3 50 mg), 4) placebo insulin injection + 150 PATRICIA K. MYDLOW, BS ROBERT L. DOBBINS, MD, PHD mg RE (RE 150 mg), and 5) placebo insulin injection + 500 mg RE (RE 500 mg). d fl Each individual received 75-g oral OBJECTIVES Remogli ozin etabonate (RE), an inhibitor of the sodium-glucose transporter glucose and identical meals during all 2, improves glucose profiles in type 2 diabetes. This study assessed safety, tolerability, pharma- cokinetics, and pharmacodynamics of RE in subjects with type 1 diabetes. treatment periods. Frequent samples were obtained for measurement of plasma RESEARCH DESIGN AND METHODSdTen subjects managed with continuous sub- glucose and insulin concentrations. Urine cutaneous insulin infusion were enrolled. In addition to basal insulin, subjects received five samples were collected for 24 h to assess randomized treatments: placebo, prandial insulin, 50 mg RE, 150 mg RE, and mg RE 500. creatinine clearance and glucose excre- d tion. Plasma samples were collected for RESULTS Adverse events and incidence of hypoglycemia with RE did not differ from placebo fl and prandial insulin groups.