RATIONALE FOR THE USE OF CANAGLIFLOZIN IN THE TREATMENT OF PATIENTS WITH DIABETES MELLITUS

Abstract

Type 2 diabetes mellitus is the most important medical and social problem of our time due to its high prevalence, high level of disability and mortality. The prevalence of type 2 diabetes mellitus in patients with chronic heart failure is important because of its direct impact on the course of chronic heart failure and the consequent changes in traditional approaches to determining individual risk of adverse events and optimal diagnostic and treatment strategies. In addition, diabetes mellitus is a risk factor for the development of chronic kidney disease and end-stage renal disease. Sodium-glucose cotransporter-2 inhibitors (SGLT-2-i) are a relatively new class of drugs used to treat type 2 diabetes mellitus. The use of SGLT-2-i in everyday clinical practice is of interest not only to endocrinologists but also to physicians in related specialties. This article presents a review of efficacy and safety studies of one drug in the SGLT-2-i class, canagliflozin. Canagliflozin is an SGLT-2 inhibitor with an additional dual insulin-independent mechanism of action compared with other members of this class, involving inhibition of not only renal SGLT-2 but also intestinal and renal SGLT-1, which may contribute to improved glycaemic control, including postprandial glycaemia. In clinical trials, canagliflozin has been shown to effectively reduce the risk of adverse cardiovascular events and to reduce the risk of heart failure in patients with type 2 diabetes mellitus. Canagliflozin's proven nephroprotective properties formed the basis for its approved indication to reduce the risk of progression of renal and cardiovascular outcomes in patients with type 2 diabetes mellitus and diabetic nephropathy. The drug's favorable safety and tolerability profile allows its widespread use in patients with type 2 diabetes mellitus. The scientific review was carried out using data from the scientometric databases PubMed, Web of Science, Scopus, Google Scholar, etc., and by analyzing scientific textbooks and monographs. The following research methods were used to select 43 papers for the article: information-analytical comparative content analysis; the most recent publications on the subject under study were selected.