Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Feb 15, 2015; 6(1): 136-144
Published online Feb 15, 2015. doi: 10.4239/wjd.v6.i1.136
Ipragliflozin: A novel sodium-glucose cotransporter 2 inhibitor developed in Japan
Tsuyoshi Ohkura
Tsuyoshi Ohkura, Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Tottori University Faculty of Medicine, Yonago, Tottori 683-8504, Japan
Author contributions: Ohkura T solely contributed to this paper.
Conflict-of-interest: The author confirm that this article content has no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Tsuyoshi Ohkura, MD, PhD, Assistant Professor, Division of Cardiovascular Medicine, Endocrinology and Metabolism, Department of Molecular Medicine and Therapeutics, Tottori University Faculty of Medicine, 36-1 Nishi-chou, Yonago, Tottori 683-8504, Japan. ohkura@med.tottori-u.ac.jp
Telephone: +81-859-386517 Fax: +81-859-386519
Received: April 24, 2014
Peer-review started: April 24, 2014
First decision: May 20, 2014
Revised: November 11, 2014
Accepted: November 27, 2014
Article in press: December 1, 2014
Published online: February 15, 2015
Abstract

Sodium-glucose cotransporter 2 (SGLT2) inhibition induces glucosuria and decreases blood glucose levels in diabetic patients and lowers hypoglycemic risk. SGLT1 is expressed in the kidney and intestine; SGLT1 inhibition causes abdominal symptoms such as diarrhea and reduces incretin secretion. Therefore, SGLT2 selectivity is important. Ipragliflozin is highly selective for SGLT2. In type 2 diabetes mellitus (T2DM), urinary glucose excretion increased to 90 g/24 h after 28 d of treatment with ipragliflozin 300 mg/d. Twelve weeks of ipragliflozin 50 mg/d vs placebo reduced glycated hemoglobin and body weight by 0.65% and 0.66 kg, respectively, in Western T2DM patients, and by 1.3% and 1.89 kg, respectively, in Japanese patients. Ipragliflozin (highly selective SGLT2 inhibitor) improves glycemic control and reduces body weight and lowers hypoglycemic risk and abdominal symptoms. Ipragliflozin can be a novel anti-diabetic and anti-obesity agent.

Keywords: Sodium-glucose cotransporter 2 inhibitor, Type 2 diabetes mellitus, Ipragliflozin, Japan

Core tip: Ipragliflozin is highly selective for sodium-glucose cotransporter 2 (SGLT2) inhibitor. Twelve weeks of ipragliflozin 50 mg/d vs placebo decreased HbA1c and body weight by 0.65% and 0.66 kg, respectively, in Western patients, and by 1.3% and 1.89 kg, respectively, in Japanese patients. The highly selective SGLT2 inhibitor ipragliflozin improves glycemic control and reduces body weight, and lowers hypoglycemic risk and abdominal symptoms. Ipragliflozin has potential as a novel anti-diabetic and anti-obesity agent.