Do we need another SGLT2 inhibitor?

Abstract

SGLT2 inhibitors have been shown to have benefits on glycaemic control, as well as on cardiovascular risk factors including weight loss, blood pressure reduction and some effects on lipid profile. They can be used in addition to other oral hypoglycaemic agents, or in addition to insulin, and the main side effects are genital mycotic infections and urinary tract infection, which can be easily treated with conventional treatment and respond well to this. Although there are slight differences in the licences for each drug, from current available data there are no clear clinical differences in the class among the three available drugs. Direct head-to-head comparisons are lacking, so it is unknown at present if slight changes in selectivity will translate into differences in efficacy, safety or side effect profile. Longer-term data and cardiovascular outcomes are awaited. Several other SGLT2 inhibitors are in development, and it is hard to see any major clinical differences emerging with these newer drugs, so at present we have no great need for another SGLT2 inhibitor.