• Sheila A Doggrell and Kerry McIntyre.
• Queensland University of Technology, School of Biomedical Sciences, Faculty of Health , GPO 2434, QLD 4002, Brisbane , Australia +61 7 3138 2015 ; +61 7 3138 1534 ; sheila.doggrell@qut.edu.au.
• Expert Opin Pharmacother. 2014 Feb 1; 15 (3): 437-41.

IntroductionInhibition of the sodium-glucose cotransporter 2 (SGLT2), to promote the excretion of glucose, is a new paradigm in the treatment of type 2 diabetes.Areas CoveredCanagliflozin is an SGLT2 inhibitor, which has been the subject of two recent clinical trials, which are evaluated.Expert OpinionStudies with canagliflozin, in subjects with type 2 diabetes, have shown that its use is associated with reductions in HbA1c and body weight and small reductions in blood pressure and triglycerides, while increasing high-density lipoprotein cholesterol and low-density lipoprotein cholesterol. As monotherapy in Japanese subjects, or in comparison with glimepiride in CANTATA-SU (CANagliflozin Treatment and Trial Analysis versus SUlphonylurea), canagliflozin causes a low incidence of hypoglycemia, and this is an advantage over glimepiride. However, one of the disadvantages with canagliflozin, which was also highlighted in CANTATA-SU, is that canagliflozin can cause urogenital infections, which are not observed with other antidiabetic drugs. The Federal Drug Administration has recently approved canagliflozin for use in type 2 diabetes, while directing that a clinical outcome safety trial be undertaken. We are concerned that canagliflozin has been approved for use in type 2 diabetes prior to a clinical outcome study of efficacy being undertaken and without the outcome of further safety testing.

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