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FDA approved Brenzavvy (bexagliflozin) for Type 2 Diabetes Glycemic ControlFDA approved Brenzavvy, a new pill for type 2 diabetes.

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Key Takeaway
Consider bexagliflozin as an adjunct to diet and exercise for glycemic control in adults with type 2 diabetes, but not in type 1 diabetes or eGFR <30.

The FDA has approved Brenzavvy (bexagliflozin), a sodium-glucose co-transporter 2 (SGLT2) inhibitor, for improving glycemic control in adults with type 2 diabetes mellitus as an adjunct to diet and exercise. The approval, announced January 20, 2023, adds a new option to the SGLT2 inhibitor class. Brenzavvy is not recommended for patients with type 1 diabetes. The recommended dose is 20 mg once daily, taken in the morning with or without food. Renal function should be assessed before initiation, and the drug is not recommended if eGFR is below 30 mL/min/1.73 m². Volume depletion should be corrected before starting therapy. The label includes data from six clinical trials, including monotherapy and combination therapy with metformin, as well as studies in patients with moderate renal impairment and those with established cardiovascular disease or at increased risk. In a 24-week monotherapy trial, bexagliflozin reduced HbA1c by 0.5% from a baseline of 8.1%, compared to a 0.1% reduction with placebo (difference -0.4%, 95% CI -0.6 to -0.1).

Clinical Details (Mechanism · Dosing · Trial Data · Warnings)
Mechanism of Action

Bexagliflozin is a sodium-glucose co-transporter 2 (SGLT2) inhibitor. It reduces renal glucose reabsorption, leading to increased urinary glucose excretion and lowered blood glucose levels.

Indication & Patient Population

Bexagliflozin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Limitation of Use: Not recommended for use to improve glycemic control in patients with type 1 diabetes mellitus.

Dosing & Administration

Recommended dose: 20 mg once daily, taken in the morning, with or without food. Do not crush or chew the tablet. Assess renal function before initiating and as clinically indicated. Correct volume depletion before initiating. Not recommended if eGFR less than 30 mL/min/1.73 m². Withhold for at least 3 days prior to major surgery or procedures associated with prolonged fasting; resume when patient is clinically stable and has resumed oral intake.

Key Clinical Trial Data

Bexagliflozin was studied as monotherapy (Trial 1) and in combination with metformin (Trials 2, 3, 4), in patients with moderate renal impairment (Trial 5), and in patients with established CVD or at increased risk (Trial 6). In Trial 1 (24-week, placebo-controlled monotherapy), bexagliflozin 20 mg reduced HbA1c by 0.5% from baseline 8.1% vs 0.1% reduction with placebo (difference -0.4%, 95% CI -0.6 to -0.1). Efficacy was noninferior to glimepiride and sitagliptin. Reductions in HbA1c were consistent across subgroups of age, sex, race, and geographic region.

Warnings & Contraindications

Not recommended for type 1 diabetes mellitus. Assess renal function before initiation; not recommended if eGFR <30 mL/min/1.73 m². Correct volume depletion before starting. Withhold for at least 3 days prior to major surgery or procedures with prolonged fasting. See label for full warnings and precautions.

Place in Therapy

Bexagliflozin is a new SGLT2 inhibitor for type 2 diabetes. It provides an additional option for glycemic control as monotherapy or in combination with metformin. Its role is similar to other SGLT2 inhibitors, but specific cardiovascular or renal outcome data beyond glycemic efficacy are not detailed in this label.

The FDA has approved a new diabetes medication called Brenzavvy (bexagliflozin). It is a once-daily pill for adults with type 2 diabetes. Brenzavvy helps lower blood sugar when used along with diet and exercise. It belongs to a class of drugs known as SGLT2 inhibitors. These drugs work by helping the kidneys remove extra sugar from the body through urine.

Brenzavvy is not for people with type 1 diabetes. Your doctor will check your kidney function before you start taking it. It is not recommended if your kidneys are severely impaired. You should also correct any dehydration before starting treatment.

This approval gives patients another option to manage their blood sugar. In clinical studies, Brenzavvy lowered HbA1c (a measure of blood sugar control) by about 0.5% more than placebo over 24 weeks. However, it is not a cure for diabetes. It is meant to be part of a comprehensive treatment plan.

If you have type 2 diabetes, talk to your doctor about whether Brenzavvy might be right for you. Your doctor can help you understand the benefits and risks based on your personal health history.

What this means for you:
Brenzavvy is a new once-daily pill for type 2 diabetes that helps lower blood sugar.

Study Details

Study typeFda approval
PublishedJan 2023
View Original Abstract ↓
1 INDICATIONS AND USAGE Bexagliflozin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Limitations of Use Bexagliflozin is not recommended for use to improve glycemic control in patients with type 1 diabetes mellitus. [see Warnings and Precautions ( 5.1 )] . Bexagliflozin is a sodium-glucose co-transporter 2 (SGLT2) inhibitor indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. ( 1 ) Limitation of Use: Not recommended for use to improve glycemic control in patients with type 1 diabetes mellitus. ( 1 )
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