Canagliflozin is in clinical development for the treatment of chronic kidney disease in adults with type 2 diabetes mellitus. Diabetes is a condition that causes blood sugar level to become too high. The majority of diabetes cases are type 2 diabetes, where the pancreas does not produce enough insulin or when the cells in the body do not respond properly to insulin. Diabetes is the leading cause of chronic kidney disease and failure in adults. People affected by chronic kidney disease have a reduced life expectancy and lower quality of life, as well as substantially increased risk of cardiovascular disease and adverse health outcomes.
Canagliflozin belongs to a class of antidiabetic drugs called SGLT2 inhibitors that act by encouraging the body to filter out more glucose from the blood and excrete it via the urine. Canagliflozin is already licensed for use in type 2 diabetes mellitus but emerging evidence has also suggested that it offers substantial kidney protection, by slowing the progression of diabetic kidney disease. Canagliflozin will offer patients with type 2 diabetes mellitus who have chronic kidney disease a single treatment option to improve both kidney function alongside blood glucose control.
Migalastat works by stabilizing the body’s own dysfunctional enzyme, so it can clear the accumulated disease substrate in patients who have amenable mutations. Migalastat is currently licenced for patients aged 16 or over with Fabry disease and an amenable mutation. If the license is extended, migalastat may offer an additional treatment option for paediatric subjects 12 to 15 years old with Fabry disease and an amenable mutation, who weight over 45Kgs.