Appearance Of Rare Ketoacidosis Side Effect, In SGLT2 Diabetes Therapies, May Lead To Slight Sales Uptick For Merck’s Januvia®/Janumet®

The effect, seen in only 20 patients thus far on SGLT2 therapy regimens, is quite rare. But when it appears, it is severe: life threatening — without immediate intervention, comas have been reported.

These newer classes of drugs, called SGLT2 inhibitors, had to now been steadily eating in to Januvia®/Janumet® (sitagliptin) market share — here in the US. I suspect this FDA warning will add mildly to Januvia’s results in 2015. We shall see. [As the graphic at right notes, there is also a very rare side effect: pancreatitis risk — associated (since 2013) with sitagliptin, to be fair.] Per WebMD, then — a bit:

. . . .A certain class of type 2 diabetes drugs can lead to a life-threatening condition called ketoacidosis, the U.S. Food and Drug Administration warns.

These prescription drugs are called sodium-glucose cotransporter-2 (SGLT2) inhibitors and include canagliflozin, dapagliflozin and empagliflozin. They work by prompting the kidneys to remove sugar in the blood through urine. . . .

The drugs are sold under the brand names: Invokana (canagliflozin), Invokamet (canagliflozin and metformin), Farxiga (dapagliflozin), Xigduo XR (dapagliflozin and metformin extended-release), Jardiance (empagliflozin), Glyxambi (empagliflozin and linagliptin). . . .

The reality of all of it is that diabetes is a very serious disease, and each therapy choice will have pluses and minuses — patient by patient. So, as I say — I’d expect only a very mild uptick for Merck’s Januvia here. Chilly and cloudy gray here. . . but onward, just the same — life goes on.


One Response

  1. Hello:
    As you have correctly said all drug has some pluses and minuses as well. The DPP4 and SGLT2 are different class of inhibitors and the side effects are to be expected. Are there any published reports out there that compares on how many Pancreatitis (Janumet) Vs ketoacidosis (Invokana etc.) per given patient population? I am just curious and you have breadth of knowledge on these clinical studies, so my question directed at you. Thanks!

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