LX4211, a dual SGLT1/SGLT2 inhibitor, improved glycemic control in patients with type 2 diabetes in a randomized, placebo-controlled trial
B Zambrowicz, J Freiman, P M Brown, K S Frazier, A Turnage, J Bronner, D Ruff, M Shadoan, P Banks, F Mseeh, D B Rawlins, N C Goodwin, R Mabon, B A Harrison, A Wilson, A Sands, D R Powell, B Zambrowicz, J Freiman, P M Brown, K S Frazier, A Turnage, J Bronner, D Ruff, M Shadoan, P Banks, F Mseeh, D B Rawlins, N C Goodwin, R Mabon, B A Harrison, A Wilson, A Sands, D R Powell
Abstract
Thirty-six patients with type 2 diabetes mellitus (T2DM) were randomized 1:1:1 to receive a once-daily oral dose of placebo or 150 or 300 mg of the dual SGLT1/SGLT2 inhibitor LX4211 for 28 days. Relative to placebo, LX4211 enhanced urinary glucose excretion by inhibiting SGLT2-mediated renal glucose reabsorption; markedly and significantly improved multiple measures of glycemic control, including fasting plasma glucose, oral glucose tolerance, and HbA(1c); and significantly lowered serum triglycerides. LX4211 also mediated trends for lower weight, lower blood pressure, and higher glucagon-like peptide-1 levels. In a follow-up single-dose study in 12 patients with T2DM, LX4211 (300 mg) significantly increased glucagon-like peptide-1 and peptide YY levels relative to pretreatment values, probably by delaying SGLT1-mediated intestinal glucose absorption. In both studies, LX4211 was well tolerated without evidence of increased gastrointestinal side effects. These data support further study of LX4211-mediated dual SGLT1/SGLT2 inhibition as a novel mechanism of action in the treatment of T2DM.
Trial registration: ClinicalTrials.gov NCT00962065 NCT01188863.
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References
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