Recently, CFDA approved the new oral SGLT-2 inhibitor——empagliflozin from Boehringer Ingelheim/Lilly to be listed in China, becoming the second listed SGLT-2 inhibitor in China, for improving glycemic control in patients with type 2 diabetes. The drug can be used as a single drug, combined with metformin or sulfonylurea drugs.

Diabetes is a chronic disease, when the pancreas can not produce enough insulin or the body can not effectively use the resulting insulin, there will be diabetes. In the diabetic patients around the world, the vast majority of people suffering from type 2 diabetes. Hyperglycemia or elevated blood sugar is a common result of diabetes without control, with the passage of time, it will cause serious damage to many systems of the human body, especially nerves and blood vessels. In 2014, 8.5% of adults over the age of 18 were suffering from diabetes; in 2015, diabetes caused 1.6 million deaths.

Currently, therapeutic agents for type 2 diabetes include biguanides (metformin), thiazolidinediones, sulfonylureas, DPP-4 inhibitors, GLP-1 analogs, and SGLT-2 inhibitors. The main pharmacological mechanism of empagliflozin is to reduce the amount of SGLT-2 (sodium-glucose co-transporter 2) responsible for glucose reabsorption in renal tubules, allowing more glucose to be removed from the urine. Currently listed SGLT-2 inhibitors mainly include AstraZeneca's dapagliflozin, Johnson & Johnson’s canagliflozin, Boehringer Ingelheim/Eli Lilly's empagliflozin, Astellas Pharma’s Ipragliflozin, Chugai Pharmaceutical Co’s Tofogliflozin and Taisho Pharmaceutical’s Luseogliflozin. Among them, AstraZeneca's dapagliflozin has been approved by CFDA in March this year and to be the first SGLT-2 inhibitors listed in China.

Since its approval in May 2014, empagliflozin has been listed in more than 80 countries around the world. In addition to a clear hypoglycemic effect, empagliflozin also has the function of lossing weight, lowering blood pressure, reducing uric acid, and has good safety, It is the first diabetes drug to significantly reduce the risk of heart attack, stroke and cardiovascular risk (although this is not included in the Chinese approval). And it does not interfere with insulin and glucagon secretion regulation pathway, so the possibility of causing low blood sugar is relatively small.

The listing of empagliflozin in China may intensify competition of the market, and inspire the research and development of SGLT-2 inhibitor in domestic enterprises, which will bring more treatment options for Chinese patients.