Lifestyle weightNICE has issued a Final Appraisal Determination (FAD) for Invokana (canagliflozin), 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. Canagliflozin also has the additional benefits of modest weight loss (2-3%) and blood pressure reduction (although is not licensed for use in weight loss or blood pressure reduction). 

This announcement comes just two months after the UK launch of canagliflozin. The NICE FAD recommends canagliflozin to be used as a treatment for adults with type 2 diabetes, as either dual therapy (in combination with metformin, only if a sulfonylurea is contraindicated or not tolerated, or where the person is at significant risk of hypoglycaemia or its consequences) or triple therapy (in combination with metformin and a sulfonylurea, or metformin and thiazolidinedione), or in combination with insulin (with or without other antidiabetic therapies).

“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.”

With final guidance due to be published in June, this NICE recommendation means that canagliflozin will soon be available on all formularies across England and Wales. 

Canagliflozin is an oral, once-daily tablet, belonging to a class of medicines called sodium glucose co-transporter 2 (SGLT2) inhibitors. It works differently to 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. 

The efficacy of canagliflozin has been studied in trials involving over 10,000 people with type 2 diabetes,1 making it one of the largest development programmes for type 2 diabetes in the world. 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.

For further information: New type 2 diabetes drug launched