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Recommendations on the proper use of SGLT2 inhibitors

  • The Committee on the Proper Use of SGLT2 InhibitorsEmail author
Report of the Committee
  • 45 Downloads

Introduction

Following the launch of the first sodium-glucose co-transporter-2 (SGLT2) inhibitor on April 17, 2014, several other SGLT2 inhibitors have followed over time, so that 6 active pharmaceutical ingredients (APIs)/7 finished pharmaceutical products (FPPs) are currently available for clinical use in Japan. Launched as a class of agents with a novel mechanism of action for the treatment of type 2 diabetes, in clinical trials, these agents have not only been associated with adverse reactions (ARs) common to conventional antidiabetic drugs, e.g., hypoglycemia; they have also been associated with those unique to this class, e.g., urogenital infections. Furthermore, their wide-ranging and complex influences on metabolism and circulation have raised concern over the occurrence of a wide spectrum of ARs associated with their use, including serious ARs. Indeed, numerous reports of ARs and adverse events (AEs) have followed soon after the launch of these agents. This has led to the...

Keywords

Hypoglycemia Ketoacidosis Dehydration 

Notes

Compliance with ethical standards

Conflict of interest

Norio Abiru received honoraria from Novo Nordisk Pharma Ltd., and Astellas Pharma Inc. NA also received research funding from ONO Pharmaceutical Co., Ltd., Bristol-Myers Squibb, and Taisho Pharmaceutical Co., Ltd. Hiroshi Ikegami received honoraria from Astellas Pharma Inc., MSD K.K., Terumo Corporation, Eli Lilly Japan K.K., Novartis Pharma K.K. and Novo Nordisk Pharma Ltd. HI also received subsidies or donations from Taisho Toyama Pharmaceutical Co., Ltd., Takeda Pharmaceutical Company Limited, Mitsubishi Tanabe Pharma Corporation, Novo Nordisk Pharma Ltd., ABBOTT JAPAN CO., LTD., Sumitomo Dainippon Pharma Co., Ltd., Johnson & Johnson K.K., Medical Company, Astellas Pharma Inc., ONO PHARMACEUTICAL CO., LTD., Kyowa Kirin Co., Ltd., DAIICHI SANKYO COMPANY, LIMITED, Nippon Boehringer Ingelheim Co., Ltd. and Bayer Yakuhin, Ltd. Nobuya Inagaki received honoraria from Kowa Pharmaceutical. NI also received research funding from AstraZeneca, Daiichi Sankyo and Mitsubishi Tanabe Pharma Corporation. NI also received subsidies or donations from Astellas Pharma Inc., MSD, Ono Pharmaceutical Co., Ltd., Sanwa Kagaku Kenkyusho Co. Ltd., Kissei Pharmaceutical, Kyowa Hakko Kirin, Sanofi, Daiichi Sankyo, Taisho Toyama Pharmaceutical Co. Ltd., Sumitomo Dainippon Pharma Inc., Takeda Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Corporation, Teijin Pharma Ltd., Eli Lilly Japan, Japan Tobacco, Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma and Novo Nordisk Pharma Ltd. Kohjiro Ueki received honoraria from Novo Nordisk, Kyowa-Kirin, Takeda Pharmaceutical Co. Ltd., Astellas Pharma Inc., Mitsubishi Tanabe Pharma Corporation, AstraZeneca, MSD, Sanofi, Ono Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Inc. and Boehringer Ingelheim. KU also received research funding from Novo Nordisk, Eli Lilly, Boehringer Ingelheim, MSD, Abbott and Astellas Pharma Inc. KU also received subsidies or donations from Sanofi, Astellas Pharma Inc., Novo Nordisk, Eli Lilly, Takeda Pharmaceutical Co. Ltd., Kyowa-Kirin, Ono Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Corporation and Sumitomo Dainippon Pharma Inc. Kohei Kaku is in the employment/leadership position/Advisory role for Sanwa Kagaku Kenkyusho Co. Ltd. KK also received honoraria from Astellas Pharma Inc., AstraZeneca, Daiichi-Sankyo, MSD, Ono Pharmaceutical Co., Ltd., Novo Nordisk Pharma Ltd., Boehringer Ingelheim Japan, Inc., Taisho Toyama Pharmaceutical Co. Ltd., Takeda Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Corporation and Kowa Pharmaceutical. KK also received subsidies or donations from Boehringer Ingelheim Japan, Inc., Taisho Toyama Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Corporation and Kowa Pharmaceutical. Takashi Kadowaki received honoraria from Abbott, Astellas Pharma Inc., AstraZeneca, Bayer, Boehringer Ingelheim, Cosmic, Daiichi Sankyo, Eli Lilly, FUJIFILM Corporation, Johnson & Johnson, Kissei Pharmaceutical, Kowa Pharmaceutical, Kyowa Hakko Kirin, Medical Review Co., Ltd., Medical View Co., Ltd., Medscape Education, Medtronic Sofamor Danek Co., Ltd., Mitsubishi Tanabe Pharma Corporation, MSD, Musashino Foods Corporation, Nipro Corporation, Novartis Pharma, Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi, Sanwa Kagaku Kenkyusho Co. Ltd., Sumitomo Dainippon Pharma Inc., Taisho Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co. Ltd. and Terumo Corporation. TK also received research funding from AstraZeneca, Daiichi Sankyo and Takeda Pharmaceutical Co. Ltd. TK also received subsidies or donations from Astellas Pharma Inc., Daiichi Sankyo, Eli Lilly, Kissei Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, MSD, Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., Sanofi, Sumitomo Dainippon Pharma Inc., Taisho Pharmaceutical Co., Ltd. and Takeda Pharmaceutical Co. Ltd. TK also belongs to endowed departments by Asahi Mutual Life Insurance Company, Boehringer Ingelheim, Kowa Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, MSD, Novo Nordisk Pharma Ltd., Ono Pharmaceutical Co., Ltd., and Takeda Pharmaceutical Co. Ltd. Yutaka Seino received honoraria from MSD, Kao, Taisho Pharmaceutical Co., Ltd., Taisho Toyama Pharmaceutical Co. Ltd., Takeda Pharmaceutical Co. Ltd., Becton, Dickinson and Company, Boehringer Ingelheim and Novo Nordisk Pharma Ltd. Masakazu Haneda received honoraria from Astellas Pharma Inc., Taisho Toyama Pharmaceutical Co. Ltd., Mitsubishi Tanabe Pharma Corporation, Boehringer Ingelheim, Taisho Pharmaceutical Co., Ltd., Kowa Pharmaceutical, Ono Pharmaceutical Co., Ltd., MSD, Novartis Pharma and Novo Nordisk. MH also received research funding from Novo Nordisk, Ono Pharmaceutical Co., Ltd., Shionogi & Co., Ltd. and Johnson & Johnson. Shinichi Sato declares that he has no conflict of interest.

Ethics policy

This article does not contain any studies with human or animal subjects performed by any of the authors.

Copyright information

© The Japan Diabetes Society 2019

Authors and Affiliations

  • The Committee on the Proper Use of SGLT2 Inhibitors
    • 1
    Email author
  1. 1.TokyoJapan

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