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Diabetologie und Stoffwechsel 2015; 10(05): 247-265
DOI: 10.1055/s-0041-107247
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Empagliflozin – Insulinunabhängige Kontrolle der Glykämieparameter bei Diabetes mellitus Typ 2 durch Inhibition des Natrium-Glukose-Cotransporters SGLT2

Empagliflozin – Insulin Independent Control of Glycaemic Parameters in Diabetes Mellitus Type 2 by Inhibition of the Sodium Glucose Linked Transporter SGLT2
B. Gallwitz
1   Medizinische Klinik IV, Universitätsklinikum Tübingen, Germany
,
L. Merker
2   Diabetes- und Nierenzentrum Dormagen, Germany
,
C. Hohberg
3   Medical Affairs Deutschland, Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany
,
V. Schmid
3   Medical Affairs Deutschland, Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany
,
E. Mönnig
4   Medizinische Abteilung Diabetes, Lilly Deutschland GmbH, Bad Homburg, Germany
,
M. D. Brendel
4   Medizinische Abteilung Diabetes, Lilly Deutschland GmbH, Bad Homburg, Germany
› Author Affiliations
Further Information

Publication History

19 May 2015

11 September 2015

Publication Date:
03 November 2015 (online)

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Correction to:

ErratumDiabetologie und Stoffwechsel 2015; 10(06): 0294-0294a
DOI: 10.1055/s-0034-1398288

Zusammenfassung

Das neue orale Antidiabetikum Empagliflozin ist ein selektiver Inhibitor des aktiven natriumabhängigen Glukosecotransporters SGLT2 (sodium glucose linked transporter 2) zur insulinunabhängigen Kontrolle des Blutzuckers bei Typ-2-Diabetes mellitus, der seit Mai 2014 in den Ländern der Europäischen Union zugelassen ist. Die SGLT2-Inhibition ist ein neuer Therapieansatz zur Blutzuckersenkung durch Hemmung der Glukosereabsorption in der Niere mit erhöhter Glukoseausscheidung über den Harn. Die Senkung des Nüchtern- und des postprandialen Blutzuckers erfolgt unabhängig von Insulinwirkung und Insulinsekretion sowie unabhängig vom Ausmaß der Insulinresistenz und des Betazellfunktionsverlustes. Es besteht kein substanzeigenes Hypoglykämierisiko. Zusätzlich führt die SGLT2-Inhibition mit Empagliflozin zur Gewichtsabnahme und Blutdrucksenkung. Dieser Übersichtsartikel erläutert das Wirkprinzip der SGLT2-Inhibition und fasst klinische Daten zu Empagliflozin in der Monotherapie, den oralen Kombinationstherapien (einschließlich gepoolter Daten) und den Kombinationstherapien mit Insulin zusammen. Der primäre Studienendpunkt war die HbA1c-Änderung. In den sieben dargestellten Studien und in der gepoolten Analyse war die mittlere HbA1c-Senkung mit Empagliflozin (10 bzw. 25 mg/Tag) klinisch relevant und statistisch signifikant versus Placebo und dem Sulfonylharnstoff Glimepirid. Je nach Studie und Dosis lagen die mittleren placebokorrigierten HbA1c-Senkungen nach 24 Wochen Therapie mit Empagliflozin bei bis zu 0,9 %.

Abstract

The new oral antidiabetic drug empagliflozin is a selective inhibitor of the active sodium glucose linked transporter 2 (SGLT2) for an insulin independent control of blood sugar in diabetes mellitus type 2; it is approved in the EU since May 2014. Inhibition of SGLT2 is a new mode of action to lower blood glucose levels by inhibiting renal glucose reabsorption resulting in increased urinary glucose excretion. Lowering of fasting and postprandial blood glucose levels occurs independent of insulin action, insulin secretion, extent of insulin resistance, and loss of beta cell function. There is no intrinsic risk for hypoglycemia. In addition, SGLT2 inhibition through empagliflozin reduces body weight and lowers blood pressure. This review describes the mode of action of SGLT2 inhibition and summarizes the clinical data available on the use of empagliflozin as single agent, when combined with other oral antidiabetics (including pooled data), and when combined with insulins. Reduction of HbA1c was the primary outcome of these studies. In all seven studies, as well as in the pooled analysis, mean HbA1c reduction with empagliflozin (10 or 25 mg/day) was clinically relevant and statistically significant versus placebo and sulfonylurea glimepiride. Depending on study design and dosage used, empagliflozin showed placebo corrected HbA1c reductions of up to 0.9 % after 24 weeks of treatment.

Schlüsselwörter

SGLT2-Inhibitor - Empagliflozin - Typ-2-Diabetes mellitus - Natrium-Glukose-Cotransporter - orales Antidiabetikum - HbA1c

Key words

SGLT2 inhibitor - empagliflozin - type 2 diabetes mellitus - sodium glucose linked transporter - oral antidiabetic medication - HbA1c
 

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