Forxiga: Novel Type 2 Diabetes Drug Wins EMEA Approval-Potential to Benefit T1D

Forxiga (dapagliflozin), manufactured by Bristol-Myers Squibb and AstraZeneca, is the first approved type 2 diabetes treatment to work by inhibiting the sodium-glucose co-transporter 2, a transporter protein in the kidneys that allows glucose to be reabsorbed into the bloodstream. Its mechanism of action prevents reabsorption of glucose and increases excretion through urine, thus reducing blood glucose levels. Most importantly, this works independent of a bodys insulin synthesis or functioning, thus implying potential to benefit people with T1D. This novel treatment for diabetes comes with the added benefits of moderate weight loss, reductions in blood pressure and indirect mechanisms of increasing pancreatic beta cell function in the longer term. The weight loss and blood pressure effects, although moderate, will be advantageous since both of those factors exacerbate diabetes and vice versa. Also, Forxiga worked both as a standalone treatment as well as in combination with other diabetes medications, providing additive benefits. Forxiga is not currently approved for use in the US.

Reference:

European Medicines Agency recommends authorization of novel treatment for type 2 diabetes

Investigators and Institutions:

Bristol Myers Squibb Pharmaceuticals and AstraZeneca Pharmaceuticals

Ramifications for Individuals with Type 1 Diabetes:

Agents such as Forxiga (and several other competitor products currently in clinical development) open up an important research approach for T1D since they work independent of a bodys insulin levels. Additionally, Forxiga does not cause hypoglycemia, a major necessity to be safely used in T1D. Data is accumulating to suggest that the T1D population is trending toward overweightedness/obesity and insulin resistance, hallmarks of the Metabolic Syndrome seen in T2D. Thus, therapeutic options that ameliorate weight gain (often a side effect of excess insulin use), reduce blood pressure and indirectly promote insulin sensitization will be welcome secondary effects that could benefit people with T1D in the longer term. It will be critical to evaluate this potential treatment option in pilot T1D clinical trials and assess its benefits and risks, as well as determine dosage in combination with an individuals insulin regimen to begin evaluating its potential in T1D. It will also be key, as with most therapeutics, to determine the patient population that will respond to Forxiga. JDRF does not recommend unapproved uses of prescription drugs.

JDRF Involvement:

JDRF was not involved with any aspect of Forxiga.