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Dapagliflozin: A Review of Its Use in Patients with Type 2 Diabetes

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Abstract

Dapagliflozin (Forxiga®, Farxiga®) is an orally administered sodium-glucose co-transporter-2 (SGLT2) inhibitor used in the management of patients with type 2 diabetes. Dapagliflozin reduces renal glucose reabsorption by inhibiting the transporter protein SGLT2 in the renal proximal tubule, thereby increasing urinary glucose excretion and reducing blood glucose levels. Its mechanism of action is independent of insulin secretion or action; therefore, dapagliflozin provides complementary therapy when used in combination with other antihyperglycaemic drugs. This article updates an earlier review of dapagliflozin and focuses on longer-term efficacy and tolerability data (e.g. from extensions of earlier clinical trials), as well as data from studies in special patient populations (e.g. history of cardiovascular disease). Numerous well-designed clinical trials with dapagliflozin, primarily as add-on therapy for 24 weeks (but also as monotherapy or initial combination therapy), have consistently demonstrated reductions in glycosylated haemoglobin, fasting plasma glucose levels and bodyweight. Extensions of these trials show the effects are maintained over longer-term follow-up periods of ≈1–4 years and dapagliflozin is generally well tolerated. Dapagliflozin has a low risk of hypoglycaemia, although the incidence varies depending on background therapy, and genital mycotic infections (particularly in women) are the most common adverse events. Dapagliflozin is not recommended in patients with moderate or severe renal impairment. In view of its unique mechanism of action and now well-established efficacy and tolerability profile, dapagliflozin is a useful treatment option in the management of type 2 diabetes, although its effects on diabetic complications remain to be evaluated.

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Disclosure

The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on the article. Changes based on any comments received were made by the author on the basis of scientific and editorial merit. Greg Plosker is a salaried employee of Adis/Springer.

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    Greg L. Plosker

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  1. Greg L. Plosker
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Correspondence to Greg L. Plosker.

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The manuscript was reviewed by: G. Derosa, University of Pavia and Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; G. Dimitriadis, 2nd Department of Internal Medicine, Research Institute and Diabetes Center, Athens University Medical School, Attikon University Hospital, Athens, Greece; L. Olansky, Department of Endocrinology, Cleveland Clinic, Cleveland, OH, USA; I. Raz, Diabetes Unit, Department of Internal Medicine, Hadassah Hebrew University Hospital, Jerusalem, Israel; A.J. Scheen, Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, CHU, Liège, Belgium.

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Plosker, G.L. Dapagliflozin: A Review of Its Use in Patients with Type 2 Diabetes. Drugs 74, 2191–2209 (2014). https://doi.org/10.1007/s40265-014-0324-3

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  • DOI: https://doi.org/10.1007/s40265-014-0324-3

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