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Published on 26 June 2014

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NICE issues positive final guidance for INVOKANA®

Janssen has welcomed the publication of Final Guidance from the National Institute for Health and Care Excellence (NICE) for canagliflozin.
Canagliflozin is a new treatment option indicated for reducing blood glucose levels in people for whom diet and lifestyle measures or treatment with other blood glucose-lowering medicines, do not provide adequate control.(1,2)
It also has the additional benefits of modest weight loss (2–4%) and blood pressure reduction (although is not licensed for use in weight loss or blood pressure reduction).(1)

Janssen has welcomed the publication of Final Guidance from the National Institute for Health and Care Excellence (NICE) for canagliflozin.
Canagliflozin is a new treatment option indicated for reducing blood glucose levels in people for whom diet and lifestyle measures or treatment with other blood glucose-lowering medicines, do not provide adequate control.(1,2)
It also has the additional benefits of modest weight loss (2–4%) and blood pressure reduction (although is not licensed for use in weight loss or blood pressure reduction).(1)
NICE recommends canagliflozin to be used as a treatment for adults with type 2 diabetes, as:

  • dual therapy: in combination with metformin, only if a sulphonylurea is contraindicated or not tolerated, or where the person is at significant risk of hypoglycaemia or its consequences;
  • triple therapy: in combination with metformin and a sulphonylurea, or metformin and thiazolidinedione; and
  • in combination with insulin: with or without other antidiabetic therapies.(2)

Canagliflozin is an oral, once-daily tablet, belonging to a class of medicines called sodium glucose co-transporter 2 (SGLT2) inhibitors. It works differently from the most commonly used treatments by blocking the reabsorption of glucose in the kidneys. The result is that glucose is excreted in the urine thereby reducing levels of blood glucose — a major goal of diabetes treatment.(1)
“Type 2 diabetes is one of the most significant health challenges of our times,” commented Professor Anthony Barnett, Emeritus Professor of Medicine, University of Birmingham and Consultant Physician, Heart of England NHS Foundation Trust Birmingham. “Ensuring new treatments, such as canagliflozin, are made available to people diagnosed with Type 2 diabetes in the UK, is a key step towards addressing the growing impact of this potentially deadly disease.”
According to the National Diabetes Audit, more than a third (34.2%) of people diagnosed with type 2 diabetes in England and Wales are currently failing to achieve recommended blood glucose levels.(3)
The NHS spends about £8.8 billion a year on treating type 2 diabetes, 80% of which goes into managing avoidable complications.(4) By helping people with type 2 diabetes improve control of blood glucose levels, their risk of developing potentially life-threatening complications can be significantly reduced, which in turn could save the NHS millions of pounds.(4,5)
“Securing positive NICE Guidance is an important milestone for canagliflozin. Janssen is pleased that people with Type 2 diabetes will now have access to a new treatment option to help them control their blood sugar levels.” commented Dr Peter Barnes, Medical Director at Janssen UK.

Side effects
Clinical studies showed canagliflozin to be generally well tolerated. The most common adverse events with canagliflozin are genital mycotic infections such as thrush, urinary tract infections and increased urination.(1) These specific adverse events were generally mild to moderate in intensity and infrequently led to discontinuation in phase III studies.(1)
Furthermore, there is a low risk of hypoglycaemia associated with canagliflozin treatment when it is used without an insulin secretagogue or insulin, and evidence to date suggests the use of canagliflozin is not associated with an increase in cardiovascular risk.(1)

References

  1. INVOKANA (canagliflozin) SmPC. Available at: https://www.medicines.org.uk/emc/searchresults.aspx?term=canagliflozin&searchtype=QuickSearch (last accessed June 2014).
  2. NICE. Canagliflozin TAG. Available at www.nice.org.uk (last accessed June 2014).
  3. National Diabetes Audit 2011-2012. Available at: www.hscic.gov.uk/catalogue/PUB12421/nati-diab-audi-11-12-care-proc-rep.pdf (last accessed June 2014).
  4. Diabetes UK: ‘State of the Nation 2013’ report. Available at: http://www.diabetes.org.uk/Documents/About%20Us/What%20we%20say/0160b-state-nation-2013-england-1213.pdf (last accessed June 2014).
  5. Diabetes UK: ‘Diabetes in the UK 2012’ Key statistics on diabetes report. Available at: http://www.diabetes.org.uk/Professionals/Publications-reports-and-resources/Reports-statistics-and-case-studies/Reports/Diabetes-in-the-UK-2012/ (last accessed June 2014).


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