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sotagliflozin (Zynquista)
Indications:
- treatment of diabetes mellitus
- adjunct therapy to insulin for diabetes mellitus type 1
- lowers HgA1c, fasting glucose, & average daily glucose levels, daily total & basal insulin dose, body weight; systolic blood pressure & diastolic blood pressure, albuminuria & hypoglycemia events [2]
- may benefit patients with diabetes mellitus & acute on chronic heart failure or chronic kidney disease [3]
- improves days alive & out of hospital for patients with diabetes mellitus & worsening heart failure [4]
Dosage:
- 200-400 mg PO QD before 1st meal of day
Adverse effects:
- increases risk of diabetic ketoacidosis [1,2]
Mechanism of action:
- inhibits SGLT1 & SGLT2 & renal tubular reabsorption of glucose
Notes:
- approved in the European Union to treat patients with type 1 diabetes
- rejected in the U.S. by the FDA because of safety concerns [3]
Interactions
drug adverse effects of hypoglycemic agents
General
SGLT-2 inhibitor; oral glucosuric agent; flozin
Database Correlations
PUBCHEM cid=24831714
References
- Susman E.
MedPage Today. June 24, 2018
Sotagliflozin Tx Tied to HbA1c Reductions in T1D -
But instances of diabetic ketoacidosis are a concern, expert says.
https://www.medpagetoday.com/meetingcoverage/ada/73675
- Buse J, et al
212-OR - Fifty-Two-Week Efficacy and Safety of Sotagliflozin,
a Dual SGLT1 and SGLT2 Inhibitor, as Adjunct Therapy to Insulin
in Adults with Type 1 Diabetes (inTandem1).
American Diabetes Association (ADA) 2018; Abstract 212-OR
- Musso G, Gambino R, Cassader M, Paschetta E.
Efficacy and safety of dual SGLT 1/2 inhibitor sotagliflozin in
type 1 diabetes: Meta-analysis of randomised controlled trials.
BMJ 2019 Apr 9; 365:l1328.
PMID: 30967375 Free Article
https://www.bmj.com/content/365/bmj.l1328
- Krumholz HN
Sotagliflozin for Diabetes Patients with Worsening Heart Failure or
Chronic Kidney Disease
NEJM Journal Watch. Nov 16, 2020
Massachusetts Medical Society
(subscription needed) http://www.jwatch.org
- Bhatt DL et al.
Sotagliflozin in patients with diabetes and recent worsening heart failure.
N Engl J Med 2020 Nov 16; [e-pub].
PMID: 33200892
https://www.nejm.org/doi/10.1056/NEJMoa2030183
- Bhatt DL et al.
Sotagliflozin in patients with diabetes and chronic kidney disease.
N Engl J Med 2020 Nov 16; [e-pub].
PMID: 33200891
https://www.nejm.org/doi/10.1056/NEJMoa2030186
- Szarek M, Bhatt DL, Steg PG et al.
Effect of sotagliflozin on total hospitalizations in patients with
type 2 diabetes and worsening heart failure: A randomized trial.
Ann Intern Med 2021 Jun 22; [e-pub].
PMID: 34152828
https://www.acpjournals.org/doi/10.7326/M21-0651