Diabetic Ketoacidosis and Related Events in the Canagliflozin Type 2 Diabetes Clinical Program
- PMID: 26203064
- PMCID: PMC4542268
- DOI: 10.2337/dc15-1251
Diabetic Ketoacidosis and Related Events in the Canagliflozin Type 2 Diabetes Clinical Program
Abstract
Objective: This study assessed the incidence of serious adverse events of diabetic ketoacidosis (DKA) among patients with type 2 diabetes treated with canagliflozin.
Research design and methods: All serious adverse events of DKA and related events (ketoacidosis, metabolic acidosis, and acidosis) from 17,596 patients from randomized studies of canagliflozin through 11 May 2015 were analyzed.
Results: Serious adverse events of DKA and related events were reported in 12 patients (0.07%), including 4 (0.07%), 6 (0.11%), and 2 (0.03%) treated with canagliflozin 100 and 300 mg and comparator, respectively; corresponding incidence rates were 0.522, 0.763, and 0.238 per 1,000 patient-years, respectively. Most patients with DKA and related events had a blood glucose >300 mg/dL (16.7 mmol/L) at presentation of DKA, were on insulin, and had DKA-precipitating factors, including some with type 1 diabetes/latent autoimmune diabetes of adulthood.
Conclusions: DKA and related events occurred at a low frequency in the canagliflozin type 2 diabetes program, with an incidence consistent with limited existing observational data in the general population with type 2 diabetes.
© 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
Comment in
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Euglycemic Diabetic Ketoacidosis: A Predictable, Detectable, and Preventable Safety Concern With SGLT2 Inhibitors.Diabetes Care. 2015 Sep;38(9):1638-42. doi: 10.2337/dc15-1380. Diabetes Care. 2015. PMID: 26294774 No abstract available.
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Comment on Erondu et al. Diabetic Ketoacidosis and Related Events in the Canagliflozin Type 2 Diabetes Clinical Program. Diabetes Care 2015;38:1680-1686.Diabetes Care. 2015 Nov;38(11):e198. doi: 10.2337/dc15-1700. Diabetes Care. 2015. PMID: 26494820 No abstract available.
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Comment on Erondu et al. Diabetic Ketoacidosis and Related Events in the Canagliflozin Type 2 Diabetes Clinical Program. Diabetes Care 2015;38:1680-1686.Diabetes Care. 2016 Jan;39(1):e18. doi: 10.2337/dc15-1956. Diabetes Care. 2016. PMID: 26696665 No abstract available.
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Response to Comment on Erondu et al. Diabetic Ketoacidosis and Related Events in the Canagliflozin Type 2 Diabetes Clinical Program. Diabetes Care 2015;38:1680-1686.Diabetes Care. 2016 Jan;39(1):e19. doi: 10.2337/dci15-0026. Diabetes Care. 2016. PMID: 26696666 No abstract available.
References
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- U.S. Food and Drug Administration. FDA drug safety communication: FDA warns that SGLT2 inhibitors for diabetes may result in a serious condition of too much acid in the blood [article online], 2015. Available from http://www.fda.gov/Drugs/DrugSafety/ucm446845.htm. Accessed 19 May 2015
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- Burr K, Nguyen A-T, Rasouli N. A case report of ketoacidosis associated with canagliflozin (Invokana). Late-breaking abstract presented at the Endocrine Society's 97th Annual Meeting & Expo, 5–8 March 2015, San Diego, CA
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