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Bexagliflozin FDA Approved for Diabetes: TheracosBio Brenzavvy

Bexagliflozin FDA Approval

Bexagliflozin brenzavvy fda approval

On 20th January, the FDA approved a new SGLT2 inhibitor, Bexagliflozin for the treatment of adults with Type 2 Diabetes [Ref].

The drug is a brand of TheracosBio by the name of Brenzavvy.

Bexagliflozin is the 5th SGLT2 inhibitor that the FDA approved for the treatment of adults with Diabetes Type 2. The other SGLT2 inhibitors that have been approved and are very commonly used are:

Bexagliflozin was approved in December 2022 for the treatment of Diabetes in cats.

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How effective is Brenzavvy Vs other SGLT2 Inhibitors?

According to the ADA 2023 guidelines, SGLT2 inhibitors are classified as “intermediate to highly potent” diabetes medicines.

The following table summarizes diabetes drugs based on their potency:

Efficacy of Type 2 Diabetes Medications (in descending order)

Class

Examples

Intermediate DPP-IV Inhibitors
  • Sitagliptin
  • Vildagliptin
  • Linagliptin
  • Alogliptin
  • Saxagliptin
Intermediate to high SGLT2 Inhibitors
  • Dapagliflozin
  • Empagliflozin
  • Canagliflozin
  • Ertugliflozin
High Metformin
  • Metformin
Thiazolidinediones
  • Pioglitazone
2nd Generation Sulfonylureas
  • Glyburide
  • Gliclazide
  • Glimepiride
High to very highly effective GLP-1 Receptor agonists
  • Dulaglutide
  • Liraglutide
  • Semaglutide
  • Exenatide
Insulin
  • Insulin analogs
  • Human Insulin
Very high potency GIP and GLP-1 Receptor agonists
  • Tirzepatide

Among the SGLT2 inhibitors, Canagliflozin is the most potent, followed by Ertugliflozin, Empagliflozin, and Dapagliflozin.

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The A1C reduction of different SGLT2 inhibitors is tabulated below:

SGLT2 Inhibitor

Dose

Percentage A1C reduction

Canagliflozin 100 mg 0.91%
300 mg ↓ 1.16%
Empagliflozin 10 mg ↓ 0.7%
25 mg ↓ 0.8%
Ertugliflozin 5 mg ↓0.6%
15 mg ↓ 0.7%
Dapagliflozin 5 mg ↓0.6%
10 mg ↓ 0.7%
Bexagliflozin 20 mg ↓ 0.5%

SGLT2 inhibitors are categorized based on their potency (Data is taken from the FDA-prescribing information of each drug):

SGLT2 Inhibitor

Dose

Percentage A1C reduction

Canagliflozin 300 mg ↓ 1.16%
Canagliflozin 100 mg ↓ 0.9%
Empagliflozin 25 mg ↓ 0.8%
Empagliflozin 10 mg ↓ 0.7%
Ertugliflozin 15 mg ↓ 0.7%
Dapagliflozin 10 mg ↓ 0.7%
Ertugliflozin 5 mg ↓ 0.6%
Dapagliflozin 5 mg ↓ 0.6%
Bexagliflozin 20 mg ↓ 0.5%

Since Bexagliflozin (Brenzavvy) is one of the least potent SGLT2 inhibitors, it might not be able to compete with other SGLT2 inhibitors.

In addition, Bexagliflozin (Brenzavvy) is contraindicated in patients with kidney disease and not recommended in patients with a CrCl of less than 30 ml/minute.

Thus, although approved by the FDA for the treatment of diabetes, it may not win the markets.

Additional studies may be needed to see the full therapeutic response of the drug.

Lastly, if the price is kept the lowest, it may be utilized by physicians for their patients who are paying from their pockets or in low-income countries.

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What do you think?

Written by Ahmed Farhan

I am an Internist practicing medicine for the last fifteen years. Over the years, I have learned that medicine is not about prescribing pills. True medical practice is helping people.
I do prescribe pills as well but the best results I get are when I motivate people to overcome their problems with little changes in their lifestyles.
Since most of my patients are obese and have diabetes, hypertension, and high cholesterol levels, I am writing at dibesity.com when free.
Dibesity, I know the correct word is diabesity. Ignore this! Be with us.
Also, you can contact me directly at dibesity.com@gmail.com

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