Empagliflozin vs canagliflozin

[Pharmacy Kid]

Empagliflozin has shown to reduce the risk of cardiovascular death in diabetics with cvd, while canagliflozin has an increased risk of bone fractures and leg/foot amputations. Would any prescribers initiate canagliflozin over Empagliflozin knowing this? Do you think canagliflozin will fall off the market eventually?

 

[Rouelle]

I wonder if over the next few years studies will come out stating that Invokana (and/or Farxiga) is non-inferior to Jardiance with regard to cardiovascular risk reduction. Wouldn't be surprising.

Either way, as the first drug in class to hit the US market , and since I dispense more of it than the other drugs in class, I don't see it going away any time soon.

 

[Old Timer]

Empagliflozin has shown to reduce the risk of cardiovascular death in diabetics with cvd, while canagliflozin has an increased risk of bone fractures and leg/foot amputations. Would any prescribers initiate canagliflozin over Empagliflozin knowing this? Do you think canagliflozin will fall off the market eventually?

The Canvas Study published in the NEJM in June showed Invokana also reducted the risk of CVD. It does have increased incidence of amputation. The problem is these drugs are new and we don't know what time will show.