Reflection in Blood

FDA Approves New Diabetes Drug

Yet another new diabetes drug — dapagliflozin, branded as Farxiga — in a class of drugs with helpful effects on weight received final FDA approval on Wednesday. The drug is the product of a joint venture in diabetes by AstraZeneca and Bristol-Meyers Squibb, soon to be wholly owned by AstraZeneca.

Dapagliflozin joins canagliflozin (Invokana) in a new class of drugs called sodium glucose co-transporter 2 (SGLT2) inhibitors that block the reabsorption of glucose by the kidney, increase glucose excretion, and thus lower blood glucose levels. It is indicated for treatment of type 2 diabetes alone and in combination with other diabetes treatments.

By causing increased glucose excretion, these SGLT2 inhibitors effectively reduce the calories available for metabolism and cause a modest reduction in weight. In a study recently published in Obesity, patients receiving canagliflozin lost 2-3% of their initial body weight over 12 weeks. While the amount of weight loss is modest, it’s a big improvement over the weight gain associated with insulin and glitazones.

A diabetes drug from another class of drugs — liraglutide (Victoza) — was submitted to FDA for expanded use at a higher dose to treat obesity.

All this is good news for people affected by obesity. Diabetes treatment is moving toward an approach than involves much more careful consideration of obesity. Where endocrinologists used to freely prescribe diabetes treatments that caused weight gain, they are avoiding it now. More thoughtful clinicians and experts are calling for an approach that starts with treating obesity as a primary disease.

Good idea.

Click here to read more from MedPage Today, click here to read more from the LA Times, click here and here to read more about the effects of SGLT2 inhibitors on weight, and click here for detailed prescribing information on dapagliflozin.

Reflection in Blood, photograph © Alden Chadwick / flickr

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