Treatment with the Sodium-Glucose Cotransporter-2 Inhibitor Bexagliflozin in Cats Newly Diagnosed with Diabetes Mellitus

Abstract: Background: Sodium-glucose cotransporter -2 (SGLT2) inhibitors improve glycemic control in human type 2 diabetes mellitus (DM) and have potential for treatment of feline DM.
Hypothesis/Objectives: The SGLT2 inhibitor, Bexagliflozin, is safe and effective as a stand-alone oral treatment for DM in naive diabetic cats.
Animals: 84 client-owned cats with naive DM.
Methods: Historically-controlled prospective clinical trial. Cats received 15 mg bexagliflozin orally once daily for 180 days. Efficacy was evaluated at day 56.
Results: Of 81 evaluable cats at day 56, at least one clinical sign of DM improved in 91% cats (Table 1) and quality of life improved in 87% cats. Improvements were generally maintained through day 180 of the study. Mean serum glucose decreased from 439.8 mg/dL (95% CI 424.2, 455.4) on day 0, to 161.4 mg/dL (95% CI 132.1, 161.5) on day 56, and 144.4 mg/dL (95% CI, 126.1, 162.6) on day 180. Mean serum fructosamine decreased from 542.5 μmol/L (95% CI, 523.0, 562.0) on day 0, to 301.3 μmol/L (95% CI 280.4, 322.2) on day 56, and 305.6 μmol/L (95% CI, 269.1, 342.0) on day 180. Serum β-hydroxybutyrate concentration decreased from 13.7 mg/dL (95% CI, 11.3, 16.1) at baseline to 2.91 mg/dL (95% CI 1.8, 4.1) on day 56, and 3.21 mg/dL (95% CI, 1.3, 7.5) on day 180.
Serious adverse events occurred in 8 cats, with three deaths. Euglycemic diabetic ketoacidosis occurred in 4 cats of which one died.
Conclusion and clinical importance: Bexagliflozin reduced hyperglycemia and clinical signs in naïve diabetic cats.