SGLT2 Inhibitors Vying for Heart, Renal Indications

Sodium glucose co-transporter 2 (SGLT2) inhibitors have already remade the diabetes drug market. Now competition for new cardiac and renal indications is heating up among three of the main drugs in the class: Janssen’s Invokana (canagliflozin), AstraZeneca’s Farxiga (dapagliflozin), and Eli Lilly/Boehringer-Ingelheim’s Jardiance (empagliflozin).

This is a high stakes contest. Heart failure costs the American health system more than $30 billion a year, and chronic kidney disease costs the Medicare program more than $84 billion.

Related: Diabetes Meds Go Beyond Blood Sugar Control​

Invokana got off to an early start when the FDA approved it as a treatment for end-stage kidney disease a year ago. The drug got a bit of a boost last month when the FDA removed a boxed warning after newer data did not show an amputation risk.

Farxiga has gotten two important nods from the FDA this year. Earlier this month it was given a breakthrough therapy designation for chronic kidney disease based on results presented this summer at the European Society of Cardiology (ESC) meeting. In May, the FDA approved Farxiga as a treatment for paients with heart failure with reduced ejection fraction.

Jardiance was also in the limelight at ESC because investigators presented results showing that, like Farxiga, it seems to haveprotective cardiovascular effects in heart failure patients with low ejection fractions. Last month Jardiance received FDA’s fast track designation for treatment following a heart attack.