SGLT2 inhibitor benefits come at a risk

Invokana 149x210 SGLT2 inhibitor benefits come at a risk A new class of diabetes drugs called SGLT2 inhibitors launched in the U.S. in 2013 are demonstrating they can effectively drive down blood sugar levels and even help users lose weight. But those benefits come at a risk, according to a speaker at the Cardiometabolic Health Congress.

SGLT2 inhibitors, or sodium-glucose cotransporter 2 inhibitors, include the brand name drugs Invokana and Invokana (which contain the active ingredient canagliflozin); Farxiga and Xigduo XR (which contain the active ingredient dapagliflozin); and Jardiance (which contains the active ingredient empagliflozin).

SGLT2 inhibitors lower blood sugar by causing the kidneys to remove the sugar from the blood through the urine. The medication is approved for individuals with type 2 diabetes along with diet and exercise. It is not approved for patients with type 1 diabetes; however, some type 1 diabetics are being treated with the medication off label.

Since the drugs have been approved, some or all have been linked to serious health conditions. In May 2015, the FDA warned that the safety labels of all SGLT2 inhibitors would be updated to include new warnings regarding an increased risk of ketoacidosis, a serious condition in which too much acid builds up in the blood. That December, the FDA warned that SGLT2 inhibitors were linked to serious urinary tract infections.

In September 2015, the FDA revised the labels of Invokana and Invokamet to include updates on bone fracture risk and new information on decreased bone mineral density. And in June of that year, the FDA slapped stronger kidney damage warnings on Invokana, Invokamet, Farxiga and Xigduo XR. In May 2016, the FDA announced it was investigating whether Invokana and Invokamet were linked to an increased risk of lower limb amputations.