Remogliflozin etabonate (

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)Statement on a nonproprietory name adopted by the USAN council
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gliflozin SGLT2 inhibitors (also called gliflozins or flozins) are a class of medications that inhibit sodium-glucose transport proteins in the nephron (the functional units of the kidney), unlike SGLT1 inhibitors that perform a similar function in the i ...

class for the treatment of

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("NASH") and type 2

diabetes Diabetes mellitus, commonly known as diabetes, is a group of common endocrine diseases characterized by sustained high blood sugar levels. Diabetes is due to either the pancreas not producing enough of the hormone insulin, or the cells of th ...

. Remogliflozin was discovered by the Japanese company

Kissei Pharmaceutical Kissei Pharmaceutical is a pharmaceutical company based in Matsumoto, Nagano, Japan. Products discovered or developed by Kissei include: * Difelikefalin * Fostamatinib (trade name Tavalisse) * Linzagolix * Mitiglinide (Glufast) * Remogliflozin eta ...

and is currently being developed by BHV Pharma, a wholly owned subsidiary of North Carolina, US-based Avolynt, and

Glenmark Pharmaceuticals Glenmark Pharmaceuticals Limited is an Indian multinational pharmaceutical company headquartered in Mumbai. History Glenmark Pharmaceuticals was founded in 1977 by Gracias Saldanha as a generic drug and active pharmaceutical ingredient manu ...

through a collaboration with BHV. In 2002, GlaxoSmithKline (GSK) received a license to use it. From 2002 to 2009, GSK carried out a significant clinical development program for the treatment of type-2 diabetes mellitus in various nations across the world and obesity in the UK. Remogliflozin etabonate's pharmacokinetics, pharmacodynamics, and clinical dose regimens were characterized in 18 Phase I and 2 Phase II investigations. Due to financial concerns, GSK stopped working on remogliflozin and sergliflozin, two further SGLT2 inhibitors that were licensed to the company, in 2009. Remogliflozin was commercially launched first in India by Glenmark in May 2019.

Clinical trials

Remogliflozin etabonate was shown to enhance urinary glucose excretion in rodents and humans. Early studies in diabetics improved plasma glucose levels. Remogliflozin etabonate has been studied at doses up to 1000 mg. A pair of 12-week phase 2b randomized clinical trials of diabetics published in 2015, found reductions in

glycated hemoglobin Glycated hemoglobin, also called glycohemoglobin, is a form of hemoglobin (Hb) that is chemically linked to a sugar. Most monosaccharides, including glucose, galactose, and fructose, spontaneously (that is, non-enzymatically) bond with hemoglob ...

and that it was generally well tolerated. In a meta-analysis published by Dutta et al. involving data from 3 randomized controlled trials (535 patients), remogliflozin was noted to have similar glycaemic efficacy (reduction in HbA1c and fasting glucose) as compared to dapagliflozin and pioglitazone. A study concluded that concomitant administration of remogliflozin etabonate, either 500 mg or 750 mg BID (twice a day), with metformin 2000 mg BID was safe and effective in patients with type 2 diabetes mellitus during the observation period.

Method of action

Remogliflozin etabonate is a pro-drug of remogliflozin. Remogliflozin inhibits the

sodium-glucose transport proteins Sodium-dependent glucose cotransporters (or sodium-glucose linked transporter, SGLT) are a family of glucose transporter found in the intestinal mucosa (enterocytes) of the small intestine (SGLT1) and the proximal tubule of the nephron (SGLT2 i ...

(SGLT), which are responsible for glucose

reabsorption In renal physiology, reabsorption, more specifically tubular reabsorption, is the process by which the nephron removes water and solutes from the tubular fluid (pre-urine) and returns them to the circulating blood. It is called ''reabsorption' ...

in the kidney. Blocking this transporter causes blood glucose to be eliminated through the urine. Remogliflozin is selective for

SGLT2 The sodium/glucose cotransporter 2 (SGLT2) is a protein that in humans is encoded by the (solute carrier family 5 (sodium/glucose cotransporter)) gene. Function SGLT2 is a member of the sodium-glucose transport proteins, sodium glucose cotra ...

References

{{Sodium-glucose transporter modulators SGLT2 inhibitors Experimental diabetes drugs Phenol ethers Pyrazoles Glucosides Experimental drugs

Clinical trials

Method of action

See also

References