Comparative pharmacokinetics of three SGLT-2 inhibitors sergliflozin, remogliflozin and ertugliflozin: an overview

Xenobiotica. 2017 Nov;47(11):1015-1026. doi: 10.1080/00498254.2016.1247219. Epub 2016 Oct 28.

Abstract

1. Several sodium-glucose cotransporter-2 (SGLT-2) inhibitors are in clinical use for the management of type 2 diabetes. The objectives of the current review were: (a) to provide a comparative pharmacokinetics including absorption, distribution, metabolism and excretory (ADME) profiles of three SGLT-2 inhibitors namely: sergliflozin, remogliflozin and ertugliflozin; (b) to provide some perspectives on possible developmental issues. 2. Based on the half-life (t1/2) values observed in humans, the rank order of the three SGLT-2 inhibitors was ertugliflozin (16 h) > remogliflozin (2-4 h) > sergliflozin (1-1.5 h). Therefore, while once a day dosing of ertugliflozin is possible, the other two drugs need to be dosed more frequently. Perhaps, the short t1/2 of sergliflozin may have contributed for its discontinuation. 3. Although there was paucity of published data on the metabolism, transporter related and excretory aspects for sergliflozin, the other two drugs provided a differentiating profile. However, the compiled data suggested that there may be a minimal or no risk of pharmacokinetic drug interaction issues associated with any of the reviewed drugs. 4. Because of the crowded development pipeline and approved SGLT-2 inhibitors, the safety and efficacy of sergliflozin, remogliflozin and ertugliflozin appear to be a key from differentiation perspective.

Keywords: Clinical pharmacokinetics; ertugliflozin; remogliflozin; sergliflozin.

Publication types

  • Review

MeSH terms

  • Blood Glucose
  • Bridged Bicyclo Compounds, Heterocyclic / pharmacokinetics*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Glucosides / pharmacokinetics*
  • Half-Life
  • Humans
  • Hypoglycemic Agents / pharmacokinetics*
  • Pyrazoles / pharmacokinetics*
  • Sodium-Glucose Transporter 2

Substances

  • Blood Glucose
  • Bridged Bicyclo Compounds, Heterocyclic
  • Glucosides
  • Hypoglycemic Agents
  • Pyrazoles
  • SLC5A2 protein, human
  • Sodium-Glucose Transporter 2
  • ertugliflozin
  • sergliflozin
  • remogliflozin etabonate