Osmotic diuresis with SGLT2 inhibition: analysis of events related to volume reduction in dapagliflozin clinical trials

Objective: Dapagliflozin reduces hyperglycemia in type 2 diabetes mellitus (T2DM) and lowers blood pressure, at least in part, secondary to mild diuresis consequent to dapagliflozin-induced glucosuria. While blood-pressure lowering may contribute to cardiovascular risk reduction, dapagliflozin-induc...

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Bibliographic Details
Published in:Postgraduate medicine 2016-05, Vol.128 (4), p.346-355
Main Authors: Johnsson, Kristina, Johnsson, Eva, Mansfield, Traci A., Yavin, Yshai, Ptaszynska, Agata, Parikh, Shamik J.
Format: Article
Language:English
Subjects:
Age Factors
Aged
Benzhydryl Compounds - adverse effects
Benzhydryl Compounds - pharmacology
Blood Pressure - drug effects
Blood Urea Nitrogen
dapagliflozin
dehydration
Diuresis - drug effects
eGFR
Female
Fractures, Bone - chemically induced
Fractures, Bone - epidemiology
Glomerular Filtration Rate - drug effects
Glucosides - adverse effects
Glucosides - pharmacology
Humans
Hypoglycemic Agents - adverse effects
Hypoglycemic Agents - pharmacology
hypotension
Hypotension, Orthostatic - epidemiology
Hypovolemia - chemically induced
Hypovolemia - epidemiology
Incidence
Male
Middle Aged
Osmosis - drug effects
Placebos - adverse effects
Polyuria - chemically induced
Polyuria - epidemiology
Randomized Controlled Trials as Topic
Risk Factors
SGLT2
Sodium Potassium Chloride Symporter Inhibitors - adverse effects
Sodium-Glucose Transporter 2
Sodium-Glucose Transporter 2 Inhibitors
syncope
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Summary:Objective: Dapagliflozin reduces hyperglycemia in type 2 diabetes mellitus (T2DM) and lowers blood pressure, at least in part, secondary to mild diuresis consequent to dapagliflozin-induced glucosuria. While blood-pressure lowering may contribute to cardiovascular risk reduction, dapagliflozin-induced diuresis may potentially contribute to adverse events (AEs) of volume reduction. The present analysis compared the frequency of AEs of volume reduction between dapagliflozin and placebo. Methods: Pooled data were assessed from 13 placebo-controlled dapagliflozin clinical trials ≤24 weeks in patients with T2DM, overall, and in those at risk (aged ≥65y, estimated glomerular filtration rate [eGFR]
ISSN:0032-5481
1941-9260
DOI:10.1080/00325481.2016.1153941