{"id":32388,"date":"2013-04-10T10:26:57","date_gmt":"2013-04-10T14:26:57","guid":{"rendered":"http:\/\/asweetlife.org\/?post_type=feature&p=32388"},"modified":"2016-01-09T03:04:30","modified_gmt":"2016-01-09T08:04:30","slug":"how-invokana-works-new-type-2-diabetes-drug-hailed-as-a-major-treatment-advance","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=32388","title":{"rendered":"How Invokana Works: New Type 2 Diabetes Drug Hailed as a Major Treatment Advance"},"content":{"rendered":"

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Approval of Invokana, new kind of type 2 diabetes drug, by the U.S. Food and Drug Administration means diabetics have a significant new tool for treating the disease, as well as for losing weight and improving their overall health.<\/p>\n

\u201cIt\u2019s not hype to say that this is a new class of drug that could provide patients with a lot of beneficial results,\u201d Dr. Zachary Bloomgarden, Clinical Professor in the Department of Medicine, Division of Endocrinology at Mount Sinai School of Medicine and a nationally renowned diabetes educator and lecturer, said about the approval of the new drug, canagliflozin, which will be sold under the brand name Invokana<\/a>. \u201cThe bottom line with this drug is that it controlled blood sugar levels without causing weight gain and caused almost no hypoglycemia. This drug could be the backbone of new treatments for type 2 diabetes.\u201d<\/p>\n

How Invokana Works<\/strong><\/h2>\n

In development for the last 13 years, Invokana employs a \u201cnovel mechanism of action\u201d to lower blood sugar in type 2 diabetics, Bloomgarden says. The medication is a sodium glucose co-transporter 2 (SGLT2) inhibitor, according to the drug\u2019s developer Janssen Pharmaceuticals, Inc., a part of Johnson & Johnson.<\/p>\n

Invokana works by inhibiting sodium glucose co-transporter 2, a carrier that aids in the reabsorption of glucose into the bloodstream through the kidneys, which occurs during the process in which blood is filtered through the kidneys. The excess glucose is then flushed out of the body, which is why Invokana also acts as a \u201cpotent diuretic,\u201d Bloomgarden said.<\/p>\n

\u201cOne of the most basic biological factors driving the diabetes and obesity epidemics is that our bodies have evolved to never waste food and energy,\u201d medical journalist Alasdair Wilkins said when describing how Invokana works<\/a>. \u201cFor most species, including our hunter-gatherer ancestors who could never be entirely sure where their next meal would come from, such aggressive conservation of energy made perfect sense. But modern humans live in an era of plentiful food, where there\u2019s far greater danger of eating too much rather than too little. SGLT-1 and SGLT-2 evolved to prevent the loss of seemingly vital sugar by transporting glucose from the kidney back into the body\u2019s circulation, with SGLT-2 reabsorbing 90% of glucose in the kidney and SGLT-1 accounting for the final 10% in the kidney.\u201d<\/p>\n

Invokana reduced the A1c of type 2 diabetics more effectively than glimepiride, or Amaryl, which works by increasing insulin production in the pancreas, according to Jimmy Ren, Ph.D., of Janssen Pharmaceuticals. It also worked with about the same effectiveness as sitagliptin, or Januvia, which inhibits enzymes and increases pancreatic function, Ren added.<\/p>\n

Invokana Side Effects, Weight Loss<\/strong><\/h2>\n

\"\"<\/a>Because Invokana is such a powerful diuretic, it can help lower a person\u2019s systolic blood pressure, which made some clinical trial subjects feel dizzy and even faint in the first three months while taking the drug. For extended periods, however, reducing blood pressure in a population of patients with typically higher than normal blood pressure as a result of their diabetes is a positive side effect.<\/p>\n

Additionally, because Invokana blocks absorption of glucose, it could reduce a person\u2019s weight. According to Janssen Pharmaceuticals, clinical trials subjects taking the drug experienced a 3 percent weight loss compared to subjects taking a placebo.<\/p>\n

This method of reducing blood sugar by blocking glucose absorption in the kidneys proved safe and effective through nine clinical trials involving 10,285 participants, according to Janssen Pharmaceuticals. The most common side effects experienced were vaginal yeast infections and urinary tract infections, according to the company.<\/p>\n

Invokana Cautions<\/strong><\/h2>\n

Even though the FDA voted 10 to five to approve Invokana, the jury is still partially out on the drug\u2019s complete safety and the long-term effects of the new class of medication. A drug called dapagliflozin, from Bristol-Myers Squibb and AstraZeneca, that also works as a SGLT2 inhibitor, for instance, was rejected for approval by the FDA in 2012 because of concerns it increased rates of bladder and breast cancers in subjects.<\/p>\n

The FDA said they are requiring Janssen Pharmaceuticals to conduct \u201cfive post marketing\u00a0studies for Invokana:<\/p>\n