Bexagliflozin Shows Promise as Adjunct Therapy for Type 2 Diabetes Management: Review

Panagiotis Stachteas from the Second Department of Cardiology in the Aristotle University of Thessaloniki, Thessaloniki, Greece, and colleagues aimed to discuss the current evidence on the efficacy and safety of bexagliflozin, which provides an important alternative treatment option for patients with T2D.

Type 2 diabetes, characterized by insulin resistance and relative insulin deficiency, affects millions worldwide and is a significant contributor to morbidity and mortality. While diet and exercise remain cornerstone strategies for managing the condition, many patients require additional pharmacological interventions to achieve optimal glycemic control and reduce the risk of complications.

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a relatively new class of oral antidiabetic agents that act by inhibiting renal sodium and glucose reabsorption. Except for their glucose-lowering effects, they have been linked with a more significant weight loss and blood pressure (BP) reduction and a lower risk of hypoglycemia than other commonly prescribed antidiabetic drugs.

On 20 January 2023, bexagliflozin became the fifth orally administered SGLT2 inhibitor to be approved by the US Food and Drug Administration (FDA) for T2D treatment as an adjunct therapy to exercise and diet in the USA after canagliflozin, dapagliflozin, ertugliflozin, and empagliflozin.

Bexagliflozin was recently approved by the FDA as an adjunct hypoglycemic therapy to lifestyle interventions such as exercise and diet to improve glycemic control in T2D patients. It is an orally administered, highly selective SGLT-2 inhibitor that confers comparable dose-dependent reductions in HbA1c and fasting glucose (FPG) levels to widely prescribed antidiabetic drugs.

As well as glycemic control, bexagliflozin successfully reduced blood pressure levels and body weight in most phase II/III clinical trials. Furthermore, it seems to be consistently safe and effective for adults with CKD stage IIIa/b.

Bexagliflozin has shown to be well tolerated and to have an acceptable safety profile with minimal adverse effects and a low hypoglycemia risk. Notably, bexagliflozin demonstrated a safe cardiovascular (CV) profile in T2D, as it was noninferior to a placebo for MACE in high-risk adults with CVD comorbidities. However, there is still a lack of solid evidence supporting the bexagliflozin's superiority to other commercially available SGLT-2 inhibitors and, thus, prioritizing its use for T2D treatment.

The study findings were published online in touchREVIEWS in Endocrinology.

Reference:

Stachteas, Panagiotis, et al. "Bexagliflozin as an Adjunct Therapy to Diet and Exercise to Improve Glycaemic Control in Adults With Type 2 Diabetes." TouchREVIEWS in Endocrinology, vol. 20, no. 1, 2024, pp. 19-24.