Impact of Sodium-Glucose Cotransporter 2 Inhibitors on Nonglycemic Outcomes in Patients with Type 2 Diabetes.

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Term Occurence Count Dictionary
dapagliflozin 20 endocrinologydiseasesdrugs
diabetic ketoacidosis 3 endocrinologydiseases
hyperglycemia 7 endocrinologydiseases
hypoglycemia 1 endocrinologydiseases
metformin 8 endocrinologydiseasesdrugs
sitagliptin 2 endocrinologydiseasesdrugs

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Select Drug Character Offset Drug Term Instance
dapagliflozin 442 4/2017AbstractThe efficacy of the sodium‐glucose cotransporter 2 (SGLT2) inhibitors canagliflozin, dapagliflozin , and empagliflozin in reducing hyperglycemia in patients with type 2 diabetes is well documented. In
dapagliflozin 4445 inhibitors are approved in the United States for the treatment of patients with T2D: canagliflozin,2 dapagliflozin ,3 and empagliflozin.4 These three agents also have marketing approval for use in the management of T2D
dapagliflozin 6224 required.6 According to meta‐analyses of data from randomized controlled trials of canagliflozin, dapagliflozin , and empagliflozin, SGLT2 inhibitor monotherapy was associated with the following significant changes
dapagliflozin 6969 the reduced risk of microvascular complications is well established. The efficacy of canagliflozin, dapagliflozin , and empagliflozin in lowering elevated blood glucose concentrations is well documented.2, 3, 4, 50,
dapagliflozin 8028 safety, bone mineral density, and ketoacidosis combined with terms for SGLT2 inhibitors, canagliflozin, dapagliflozin , or empagliflozin. The reference lists from retrieved articles, as well as those from relevant review
dapagliflozin 8250 articles, were also considered. Data from U.S. prescribing information (product label) for canagliflozin, dapagliflozin , and empagliflozin and relevant drug safety information from the U.S. Food and Drug Administration (FDA)
dapagliflozin 10451 placebo once/day.13A 24‐week randomized double‐blind placebo‐controlled phase 3 trial (n=485) of dapagliflozin 2.5, 5, or 10 mg, or placebo once/day.14A 24‐week randomized double‐blind placebo‐controlled phase
dapagliflozin 10887 or glimepiride 6 or 8 mg once/day.16Double‐blind, placebo‐controlled, phase 3 trial (n=182) of dapagliflozin 10 mg or placebo once/day added to open‐label metformin for a 24‐week double‐blind treatment period
dapagliflozin 11253 empagliflozin 25 mg or glimepiride as add‐on to metformin.18bReview of the cardiovascular effects of dapagliflozin .19cData are percent mean changes.John Wiley & Sons, LtdReduction in Blood PressureStudies of SGLT2 inhibitors
dapagliflozin 18835 investigation.Cardiovascular outcome trials for canagliflozin (CANVAS; ClinicalTrials.gov identifier NCT01032629), dapagliflozin (DECLARE‐TIMI58; ClinicalTrials.gov identifier NCT01730534), and ertugliflozin (VERTIS CV; ClinicalTrials.gov
dapagliflozin 20725 regular basis.2, 3, 4Following postmarketing reports of acute kidney injury with canagliflozin and dapagliflozin , the FDA reinforced the existing warning in the drug labels of these agents to include information on
dapagliflozin 22034 returned toward baseline levels by the end of each study. Similar findings have been observed with dapagliflozin treatment in patients with moderate renal impairment, where initial reductions in eGFR were not sustained
dapagliflozin 26621 expected to be reported later in 2017 and in 2020, respectively. A study to evaluate the effect of dapagliflozin on blood glucose level and renal safety in patients with T2D and moderate renal impairment, CKD stage
dapagliflozin 28272 selectivity for SGLT2 over SGLT1 (> 2500‐fold) versus agents including tofogliflozin (> 1875‐fold), dapagliflozin (> 1200‐fold), ipragliflozin (> 550‐fold), and canagliflozin (> 250‐fold), suggesting that empagliflozin
dapagliflozin 30463 receiving canagliflozin 100 mg and 300 mg once/day, respectively.2 Similar rates of UTIs were reported for dapagliflozin (3.7% for placebo vs 5.7% and 4.3% for dapagliflozin 5 mg and 10 mg once/day, respectively).3 Rates
dapagliflozin 30516 respectively.2 Similar rates of UTIs were reported for dapagliflozin (3.7% for placebo vs 5.7% and 4.3% for dapagliflozin 5 mg and 10 mg once/day, respectively).3 Rates of UTIs for empagliflozin 25 mg once/day and placebo
dapagliflozin 32235 and symptoms of DKA, regardless of ambient plasma glucose levels, and the U.S. product labeling for dapagliflozin , canagliflozin, and empagliflozin was subsequently updated (December 2015).46In a retrospective analysis
dapagliflozin 32757 incidence rates of 0.522, 0.763, and 0.238 per 1000 patient‐years).49 Data from > 18,000 patients in the dapagliflozin clinical trial program indicate that < 0.1% of patients with T2D experienced DKA events.53 For empagliflozin,
dapagliflozin 36179 canagliflozin in September 2015 to include a warning about risks of bone fracture and decreased BMD.58For dapagliflozin and empagliflozin, there is no apparent relationship between drug administration and the occurrence
dapagliflozin 36749 after 50 weeks of therapy showed no significant changes in these markers for patients who received dapagliflozin versus placebo.59Sodium‐glucose cotransporter 2 inhibition may have an adverse effect on bone turnover
metformin 5262 general recommendations for glucose‐lowering therapy in patients with T2D, initial treatment with metformin (if not contraindicated) is preferred, and SGLT2 inhibitors are one of several second‐line options
metformin 5395 contraindicated) is preferred, and SGLT2 inhibitors are one of several second‐line options for dual therapy with metformin , as well as a possible option for triple therapy.5 The current consensus statement from the American
metformin 5751 inhibitors as one of several options for monotherapy in patients with contraindications or intolerance to metformin and as one possible component of dual and triple therapy, either added to metformin, with or without
metformin 5835 intolerance to metformin and as one possible component of dual and triple therapy, either added to metformin , with or without other glucose‐lowering agents, or in a regimen without metformin.6 In addition, the
metformin 5919 either added to metformin, with or without other glucose‐lowering agents, or in a regimen without metformin .6 In addition, the AACE/ACE treatment algorithm considers SGLT2 inhibitors to be an option for addition
metformin 6574 reductions in systolic blood pressure (BP) of ~3.6–5.1 mm Hg.7, 8, 9 Compared with active comparators ( metformin , sulfonylureas, and/or sitagliptin), these SGLT2 inhibitors showed similar or greater reductions in
metformin 10949 placebo‐controlled, phase 3 trial (n=182) of dapagliflozin 10 mg or placebo once/day added to open‐label metformin for a 24‐week double‐blind treatment period followed by a 78‐week extension period (site and patient
metformin 11200 active‐controlled double‐blind phase 3 trial (n=1549) of empagliflozin 25 mg or glimepiride as add‐on to metformin .18bReview of the cardiovascular effects of dapagliflozin.19cData are percent mean changes.John Wiley
sitagliptin 6607 (BP) of ~3.6–5.1 mm Hg.7, 8, 9 Compared with active comparators (metformin, sulfonylureas, and/or sitagliptin ), these SGLT2 inhibitors showed similar or greater reductions in HbA1c,7, 8, 9 as well as significant
sitagliptin 10616 randomized double‐blind placebo‐controlled phase 3 trial (n=899) of empagliflozin 10 or 25 mg, sitagliptin 100 mg, or placebo once/day.15A A 52‐week randomized double‐blind active‐controlled phase 3 noninferiority
Select Disease Character Offset Disease Term Instance
diabetic ketoacidosis 1566 infections, as well as the potential risk for serious adverse events such as dehydration, development of diabetic ketoacidosis , serious urinary tract infections, and bone fractures. The findings of ongoing research will help to
diabetic ketoacidosis 31203 such infections promptly, if indicated.Diabetic KetoacidosisPostmarketing reports of serious cases of diabetic ketoacidosis (DKA) resulting in emergency department visits or hospitalization have been recorded for a small number
diabetic ketoacidosis 31618 occurred in patients without significant hyperglycemia and were therefore diagnosed as “euglycemic diabetic ketoacidosis .”47, 48, 49, 50 Published case reports have also documented episodes of DKA in patients receiving
hyperglycemia 487 sodium‐glucose cotransporter 2 (SGLT2) inhibitors canagliflozin, dapagliflozin, and empagliflozin in reducing hyperglycemia in patients with type 2 diabetes is well documented. In addition, positive effects have been observed
hyperglycemia 3538 patients with type 2 diabetes (T2D), the expression and activity of SGLT2 are increased in the presence of hyperglycemia , which results in additional glucose reabsorption and maintenance of elevated blood glucose concentration.1
hyperglycemia 3849 is to reduce renal glucose reabsorption and increase urinary glucose excretion, and thereby reduce hyperglycemia . Pharmacologic inhibition of SGLT2 in the kidney reduces the capacity for renal glucose reabsorption
hyperglycemia 15006 Overall Cardiovascular RiskAs the reported clinical effects of SGLT2 inhibitors include reduction of hyperglycemia , weight loss, and BP reduction, treatment would be expected to confer CV benefits.28 However, the effect
hyperglycemia 18021 effects, reduced albuminuria, and reduced uric acid level, as well as the established effects on lowering hyperglycemia , weight, BP, and body fat mass.10 The observed reductions in CV events and CV mortality are not fully
hyperglycemia 19603 mechanism of action of SGLT2 inhibitors requires adequate renal function for effective reduction of hyperglycemia , these agents are contraindicated in people with severe renal impairment. Thus, the current U.S. prescribing
hyperglycemia 31558 implying off‐label use.47 Some of these cases of DKA have occurred in patients without significant hyperglycemia and were therefore diagnosed as “euglycemic diabetic ketoacidosis.”47, 48, 49, 50 Published case
hypoglycemia 38401 management of T2D, including weight reduction and the need for well‐tolerated treatment with a low risk of hypoglycemia , in addition to the convenience of once‐daily oral dosing.5 In addition, SGLT2 inhibitors offer other

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