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From The Medical Letter on Drugs and Therapeutics
June 19, 2018

Ertugliflozin for Type 2 Diabetes

JAMA. 2018;319(23):2434-2435. doi:10.1001/jama.2018.5840

The FDA has approved the sodium-glucose co-transporter 2 (SGLT2) inhibitor ertugliflozin (Merck) for treatment of adults with type 2 diabetes, both alone (Steglatro) and in fixed-dose combinations with metformin (Segluromet) and sitagliptin (Steglujan). Ertugliflozin is the fourth SGLT2 inhibitor to be approved in the US. All four are available in combination with metformin and three are available in combination with a dipeptidyl peptidase-4 (DPP-4) inhibitor.

SGLT2 inhibitors decrease renal glucose reabsorption and increase urinary glucose excretion, reducing fasting and postprandial blood glucose levels (Table 1). When used as monotherapy or in addition to other drugs, they reduce A1C by 0.5%-1%. SGLT2 inhibitors also reduce systolic blood pressure by 3-6 mm Hg and have been associated with an average weight loss of 0.1-4 kg.1 The SGLT2 inhibitor empagliflozin (Jardiance) is FDA-approved for use to decrease the risk of cardiovascular death in adults with type 2 diabetes and cardiovascular disease.2