Canaaliflozin integrando la evidencia clínica actual canagliflozin: integrating current clinical evidence

Abstract

SGLT2 inhibitors (SGLT2i) have profoundly marked the aca-demics and practice in the field of endocrinology. In a short time, these drugs have gained a privileged position in the therapeutic schemes for diabetes mellitus (DM). This behavior has been propelled by the alarming epidemiologic trends shown by this disease worldwide, which urge for the inclusion of new treatment strategies. Canagliflozin (CFZ) was the first SGLT2i to show significant clinical efficacy and then to be subsequently introduced into practice. Indeed, CFZ has proved efficacious consistently in the treatment of type 2 DM for glycemic control, as well as additional effects such as a significant decrease in systolic blood pressure, serum triglyc-erides, and body weight; along with a reduction in cardiovas-cular risk, and renoprotective effect. Upon the avalanche of evidence substantiating the efficacy of SGLT2i, the importance of their adverse effects has also been underlined. In this regard, it is interesting that they show a relatively low risk of hypoglycemia, and although the risk of urinary infections and diabetic ketoacidosis may be worrisome, their tolerability profile tends to be relatively safe. On the other hand, CFZ has also been evaluated in the treatment of type 1 DM in combination with insulin therapy, with positive results, and a similar adverse effect profile. CFZ and SGLT2i may represent an invaluable option for the current treatment of DM. Thus, this review integrates clinical evidence on this drug to date.