Download Invokana (Canagliflozin) – Inhibitor of Sodium Glucose

Invokana (Canagliflozin) – Inhibitor of Sodium Glucose Cotransporter 2 (SGLT2)
Invokana is a once daily oral agent (tablet) used to treat patients with type 2 diabetes.
MOA: Inhibition of SGLT2 reduces resorption of glucose in the kidney, resulting in increased urinary glucose excretion,
with a consequent lowering of plasma glucose levels as well as weight loss.
Contraindications: Clinicians should not use canagliflozin to treat patients with type 1 diabetes, or patients with type 2
diabetes who have increased ketones in their blood or urine, or severe renal impairment or end-stage renal disease, or
those receiving dialysis.
Side effects: Most common: vaginal yeast infection, urinary tract infection and increased urination. Hypoglycemia (<5%),
dehydration, dizziness or fainting, hyperkalemia
Positive effects: Reduction in body weight and systolic blood pressure
Pre-Marketing Studies:

Canagliflozin 300mg vs Januvia 100mg in patients taking metformin + sulfonylurea (Study DIA3015 enrolled 755
patients)
Average decrease in A1C levels 1%
Weight Loss average 2.5% (5 pounds)
Decrease in systolic blood pressure 5.1%
Increase HDL 7.6%
Increase LDL 11.7%

Canagliflozin vs Glimepiride in patients on max dose of metformin (Study DIA3009 enrolled 1450 patients)
A1C reductions nearly identical with 100mg dose canagliflozin
A1C reductions with 300mg dose canagliflozin superior 0.93% compared to glimepiride 0.81%
Weight loss: 100mg canagliflozin average loss of 4.2%, 300mg average weight reduction of 4.7% (10 pounds)
Less risk of hypoglycemia compared to glimepiride, 5.6% vs 34.2%
Decrease in systolic blood pressure 4.6% (300mg) 3.3% (100mg)
Increase HDL 9% (300mg) 7.9% (100mg)
Increase LDL 14.1% (300mg) 9.6% (100mg)
Post-Marketing Studies:

CANVAS -- Canagliflozin Cardiovascular Assessment Study (Ongoing). Assess canagliflozin in the treatment of
patients with type 2 diabetes with regard to cardiovascular risk for major adverse cardiac events. Other objectives
include evaluating the overall safety, tolerability, and effectiveness of canagliflozin.
An enhanced pharmacovigilance program to monitor for malignancies, serious cases of pancreatitis, and other
adverse events
A bone safety study
A pediatric pharmacokinetic and pharmacodynamics study
A pediatric safety and efficacy study
-Clarke, Toni. "FDA Approves Johnson & Johnson Diabetes Drug, Canagliflozin." Reuters. Thomson Reuters, 29 Mar. 2013. Web. 01 Apr. 2013.
-Nainggolan, Lisa. "FDA Approves Canagliflozin, a First-in-Class Diabetes Drug." Medscape Log In. N.p., 29 Mar. 2013. Web. 01 Apr. 2013.
-"CANVAS - CANagliflozin CardioVascular Assessment Study." Clinical Trials. N.p., n.d. Web. 01 Apr. 2013.
-FDA Approves Invokana to Treat Type 2 Diabetes. N.p., n.d. Web. 01 Apr. 2013
-Berkrot, Bill. "Johnson & Johnson Diabetes Drug Tops Older Therapies in Studies." Reuters. Thomson Reuters, 09 June 2012. Web. 02 Apr. 2013.
-"Canagliflozin Provided Substantial and Sustained Glycemic Improvements as Monotherapy and in Add-On Combinations in Adults with Type 2 Diabetes in Five Phase 3 Studies." Johnson & Johnson. Jansen Research & Development, 09 June 2012. Web. 02 Apr. 2013.