Invokana may reduce albuminuria and renal function decline in diabetic patients

Canagliflozin, a sodium-glucose cotransporter 2 inhibitor (SGLT-2), (brand: Invokana,  Janssen Pharmaceutica) may have renal protective effects independent of glucose control, according to a study in JASN.   A secondary analysis of data from the randomized clinical trial of canagliflozin vs. glimepiride was undertaken for patients with Type 2 diabetes mellitus taking metformin.

 

Results demonstrated significantly less decline in eGFR and less albuminuria at the end of the 2 year follow up period for the canagliflozin groups (100 mg and 300 mg) vs. glimepiride group, despite the similar declines in HgbA1c (0.81%, 0.82%, and 0.93%, respectively, at 1 year and 0.55%, 0.65%, and 0.74%, respectively, at 2 years). eGFR declines in the glimepiride, canagliflozin 100 mg, and canagliflozin 300 mg groups were 3.3, 0.5, and 0.9 ml/min per 1.73 m2 per year (P<0.01 for each canagliflozin group versus glimepiride). Subgroup analysis of patients who began the study with a urinary albumin-to-creatinine ratio ≥30 mg/g showed a larger decrease in the urinary albumin-to-creatinine ratio with canagliflozin 100 mg or 300 mg compared with glimepiride (31.7% and 49.3%, respectively).

 

Reduction in albuminuria is similar to previous studies of two other SGLT-2 inhibitors, empagliflozin (Jardiance, Boehringer Ingelheim Pharmaceuticals) and dapagliflozin (Farxiga, AstraZeneca). However, these studies did not look at eGFR decline. These results infer a renoprotective effect of SGLT-2 inhibitors beyond the improvement in glycemic control alone.

 

Invokana was approved in March 2013 for the treatment of Type 2 diabetes mellitus. Johnson & Johnson (JNJ) is the parent company of Janssen Pharmaceutica.

 

 

– Biocoast Capital is an advisory and investment firm for the finance and life science industries.  We invest in novel drugs, medical devices and diagnostics that have the potential to revolutionize the healthcare industry.  We provide consulting services to some of the most exciting healthcare and finance companies in the world.  Biocoast Capital and the author has no relevant financial or nonfinancial relationships to Janssen Pharmaceutica.