Bexagliflozin in type 2 diabetes: a profile of its use

Bexagliflozin (Brenzavvy^®), the fifth sodium-glucose transport 2 (SGLT2) inhibitor to be approved in the USA, is a useful option to consider for the treatment of type 2 diabetes mellitus (T2DM). Developed to be more affordable than existing SGLT2 inhibitors, bexagliflozin is indicated in the USA for use as an adjunct to diet and exercise to improve glycemic control in adults with T2DM. It is taken orally once daily in the morning, with or without food. Data from randomized, double-blind, placebo-controlled phase 3 clinical trials show that bexagliflozin significantly improves glycemic control when used as monotherapy and in combination with other antidiabetic medications in adults with inadequately controlled T2DM, including in patients with moderate kidney impairment or at increased risk of cardiovascular events. Noninferiority to sitagliptin, glimepiride (titrated up to a maximum dose of 6 mg), and dapagliflozin in improving glycemic control was also demonstrated in phase 3 trials. Bexagliflozin is generally well tolerated, with a tolerability and safety profile consistent with that of other SGLT2 inhibitors.