sotagliflozin (Zynquista)
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Indications
- treatment of diabetes mellitus
- adjunct therapy to insulin for diabetes mellitus type 1
- lowers HgA1c, fasting glucose, & average daily glucose levels, daily total & basal insulin dose, body weight; systolic blood pressure & diastolic blood pressure, albuminuria & hypoglycemia events[2]
- may benefit patients with diabetes mellitus & acute on chronic heart failure or chronic kidney disease[3]
- improves days alive & out of hospital for patients with diabetes mellitus & worsening heart failure[4]
- reduces risk of myocardial infarction & stroke in high-risk patients with type 2 diabetes, chronic kidney disease, & cardiovascular risk factors[5]
- adjunct therapy to insulin for diabetes mellitus type 1
Dosage
Adverse effects
- increases risk of diabetic ketoacidosis[1][2]
- drug adverse effects of hypoglycemic agents
- drug adverse effects of oral glucosuric agent; SGLT-2 inhibitor; flozin
Mechanism of action
- inhibits SGLT1 & SGLT2 & renal tubular reabsorption of glucose
Notes
- approved in the European Union to treat patients with type 1 diabetes
- rejected in the U.S. by the FDA because of safety concerns[3]
More general terms
References
- ↑ Jump up to: 1.0 1.1 Susman E. MedPage Today. June 24, 2018 Sotagliflozin Tx Tied to HbA1c Reductions in T1D - But instances of diabetic ketoacidosis are a concern, expert says. https://www.medpagetoday.com/meetingcoverage/ada/73675
Buse J, et al 212-OR - Fifty-Two-Week Efficacy and Safety of Sotagliflozin, a Dual SGLT1 and SGLT2 Inhibitor, as Adjunct Therapy to Insulin in Adults with Type 1 Diabetes (inTandem1). American Diabetes Association (ADA) 2018; Abstract 212-OR - ↑ Jump up to: 2.0 2.1 2.2 Musso G, Gambino R, Cassader M, Paschetta E. Efficacy and safety of dual SGLT 1/2 inhibitor sotagliflozin in type 1 diabetes: Meta-analysis of randomised controlled trials. BMJ 2019 Apr 9; 365:l1328. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30967375 Free Article https://www.bmj.com/content/365/bmj.l1328
- ↑ Jump up to: 3.0 3.1 3.2 Krumholz HN Sotagliflozin for Diabetes Patients with Worsening Heart Failure or Chronic Kidney Disease NEJM Journal Watch. Nov 16, 2020 Massachusetts Medical Society (subscription needed) http://www.jwatch.org
Bhatt DL et al. Sotagliflozin in patients with diabetes and recent worsening heart failure. N Engl J Med 2020 Nov 16; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33200892 https://www.nejm.org/doi/10.1056/NEJMoa2030183
Bhatt DL et al. Sotagliflozin in patients with diabetes and chronic kidney disease. N Engl J Med 2020 Nov 16; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33200891 https://www.nejm.org/doi/10.1056/NEJMoa2030186 - ↑ Jump up to: 4.0 4.1 Szarek M, Bhatt DL, Steg PG et al. Effect of sotagliflozin on total hospitalizations in patients with type 2 diabetes and worsening heart failure: A randomized trial. Ann Intern Med 2021 Jun 22; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34152828 https://www.acpjournals.org/doi/10.7326/M21-0651
- ↑ Jump up to: 5.0 5.1 Arrarwal R et al Effect of sotagliflozin on major adverse cardiovascular events: a prespecified secondary analysis of the SCORED randomised trial. Lancet Diabetes & Endocrinology 2025. Feb 14 Not yet indexed in PubMed https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00362-0/abstract