The SGLT2 Inhibitor Empagliflozin for the Treatment of Type 2 Diabetes Mellitus:
a Bench to Bedside Review
#MMPMID24729157
McGill JB
Diabetes Ther
2014[Jun]; 5
(1
): 43-63
PMID24729157
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INTRODUCTION: The treatment of type 2 diabetes mellitus (T2DM) continues to pose
challenges for clinicians and patients. The dramatic rise in T2DM prevalence,
which has paralleled the rise in obesity, has strained the healthcare system and
prompted the search for therapies that not only effectively treat hyperglycemia,
but are also weight neutral or promote weight loss. In most clinical situations
after diagnosis, patients are advised to adopt lifestyle changes and metformin is
initiated to help control blood glucose levels. However, metformin may not be
tolerated, or may not be sufficient for those with higher glucose levels at
diagnosis. Even among those who have initial success with metformin, the majority
eventually require one or more additional agents to achieve their treatment
goals. Because T2DM is a progressive disease, the requirement for combination
treatment escalates over time, driving the need for therapies with complementary
mechanisms of action. METHODS AND RESULTS: Online public resources were searched
using "empagliflozin", identifying 32 articles in PubMed, and 12 abstracts
presented at the 2013 American Diabetes Association meeting. Peer-reviewed
articles and abstracts describing preclinical studies and clinical trials were
retrieved, and relevant publications included in this review. Trials registered
on clinicaltrials.gov were searched for ongoing empagliflozin studies.
CONCLUSION: The sodium-glucose co-transporter 2 (SGLT2) inhibitors are of great
interest since they provide a novel, insulin-independent mechanism of action. The
SGLT2 inhibitor empagliflozin has demonstrated promising pharmacodynamic and
pharmacokinetic properties. In clinical trials, empagliflozin has demonstrated a
good efficacy and safety profile in a broad range of patients with T2DM, and
appears to be an attractive adjunct therapeutic option for the treatment of T2DM.
Ongoing trials, including patients with T2DM and comorbidities such as
hypertension, are expected to provide important additional data, which will
further define the role of empagliflozin in a growing movement toward
individualized approaches to diabetes care.
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