Pleiotropic effects of ipragliflozin

Abstract

Type 2 diabetes mellitus and its complications is a serious threat to the health and lives of the world's population. Among the causes of death in type 2 diabetes mellitus are both cardiovascular and non-vascular causes. Sodium-glucose cotransporter type 2 inhibitors are well-established drugs for the treatment of type 2 diabetes mellitus with various hemodynamic and metabolic effects. The range of pleiotropic effects is quite wide and includes an improvement in the lipid profile, a decrease in insulin resistance and body weight, a decrease in the risk of adverse cardiovascular outcomes, nephroprotection, as well as a positive effect on the course of non-alcoholic fatty liver disease. Recent data also testify to the antiproliferative effects of this group of drugs. Ipragliflozin is one of the representatives of the class of sodium-glucose cotransporter type 2 inhibitors, which is effective in terms of glycemic control in monotherapy and in combination with other hypoglycemic drugs. The BRIGHTEN and SPOTLIGHT studies have shown an association of ipragliflozin with increased HDL and lower triglycerides. Ipragliflozin contributes to the reduction of insulin resistance and body weight, as confirmed by the PRIME-V and ILLUMINATE studies. In some cases, regression of LV hypertrophy and a decrease of NT-proBNP were shown when taking ipragliflozin. The effect on the course of non-alcoholic fatty liver disease and the reduction of fibrosis, confirmed by liver biopsy, in patients with type 2 diabetes is the advantage of ipragliflozin. There is also evidence of the antiproliferative efficacy of ipragliflozin in various types of malignant neoplasms. The review highlights the effectiveness of ipragliflozin in relation to dyslipidemia, insulin resistance, cardiovascular outcomes in patients with type 2 diabetes mellitus, presents data on the positive effect of the drug on the course of NAFLD and type 2 diabetes, and also considers possible mechanisms of the antiproliferative effect of the drug.

Keywords

• type 2 diabetes mellitus
• ipragliflozin
• dyslipidemia
• hyperuricemia
• insulin resistance
• heart failure
• nash
• cancer