CANTATA-SU Trial - Role of SGLT2 Inhibitors for DM Type 2

Amanda Schartel, Pharm.D.
Sarah Anderson, Pharm.D., BCPS
Susan Cornell, Pharm.D., CDE
Reviewed By: 
Stuart T. Haines, Pharm.D., BCPS, BCACP
Christine Choy, Pharm.D., BCPS
Cefalu WT, Leiter LA, Yoon KH, et al. Efficacy and safety of canagliflozin versus glimepiride in patients with type 2 diabetes inadequately controlled with metformin (CANTATA-SU): 52 week results from a randomised, double-blind, phase 3 non-inferiority trial. Lancet 2013; 382: 941-50.

This is a brief review of the CANTATA-SU trial and a discussion about the role of sodium glucose co-transporter 2 (SGLT2) inhibitors for the treatment of type 2 diabetes.

Are medications in this new class of agents something we should consider earlier in the treatment of type 2 diabetes?  Or perhaps even for the treatment of type 1 diabetes?  Are you concerned about their adverse effects and long-term safety?  Tell us what you think by posting a comment.



The role of SGLT2 inhibitors though unclear, yet may still have an important role in diabetes management. Therefore, before we disregard the SGLT2 inhibitors as a class, we do need to remember that while dapagliflozin 10 mg was noninferior to metformin in reducing A1c, it was superior in reducing FPG -46 mg/dl vs -35 mg/dl and superior in reducing and sustaining fat weight loss 2.7 kg vs. 1.4 kg. It would be interesting to see what the SGLT-2 inhibitors in various clinical trials contribute to overall glycemic control but most importantly cardiovascular risk reductions (For more info see Diabetes Metab Res Rev 2013; 29:347-56)