Long-term Safety and Efficacy of the SGLT2 Inhibitor Bexagliflozin for Treatment of Diabetic Cats

Abstract:

Background: The sodium-glucose cotransporter inhibitor (SGLT2i) bexagliflozin improved glycemic control and decreased clinical signs of diabetes mellitus (DM) in 84% (68/81) of naive diabetic cats in an 180-day study published previously. Cats completing this study then enrolled in an extended use study to assess durability of glycemic control and adverse event frequency. Hypothesis/

Objectives: Bexagliflozin is a safe and effective long-term once daily oral treatment for DM in cats. Animals: 69 diabetic cats that completed 180 days of bexagliflozin treatment and continued into an extended use study.

Methods: Prospective clinical trial. Cats received 15 mg bexagliflozin orally once daily and were revaluated every 56 days until study removal or study closure.

Results: 35 male and 34 female cats with a median age of 10.8 years and a median body weight of 5.4 kg were enrolled. 68% (47/69) of cats remained in the study for a median duration of 406 days (range 219-657); 17% (12/69) withdrew and 14% (10/69) were euthanized most commonly due to neoplasia (4/10). Declining BCS was associated with withdrawal. Clinical signs of DM were controlled in 78% of cats. The mean serum glucose concentrations remained between 80 and 252 mg/dl and the mean fructosamine concentration remained within the reference range during the study. Laboratory abnormalities included increased beta-hydroxybutyrate (9 cats), hypercholesterolemia (12 cats), and hypercalcemia (14 cats). Renal function remained unchanged in 80% of cats. Conclusion and clinical importance: Bexagliflozin was well tolerated; improved glycemic control and clinical signs of DM were maintained in most cats long-term.