JARDIANCE® (Empagliflozin)
The content on this website is in relation to adult patients
Indications
Chronic kidney disease
JARDIANCE® is indicated in adults for the treatment of chronic kidney disease.1
Type 2 diabetes
JARDIANCE® is indicated for the treatment of adults with insufficiently controlled type 2 diabetes mellitus as an adjunct to diet and exercise
- as monotherapy when metformin is considered inappropriate due to intolerance
- in addition to other medicinal products for the treatment of diabetes 1
According to the 5.1 section of the SmPC, both improvement of glycaemic control and reduction of cardiovascular morbidity and mortality are an integral part of the treatment of type 2 diabetes.1
Heart failure
JARDIANCE® is indicated in adults for the treatment of symptomatic chronic heart failure.1
Mechanism of Action
SGLT2 inhibitors have multiple effects on metabolism and fluid balance in the Cardio-Renal-Metabolic (CRM) interconnected system1
Sodium-glucose cotransporter 2 (SGLT2) is highly expressed in the kidney.1 By blocking reuptake of glucose and sodium in the kidneys SGLT2 inhibitors increase the excretion of both in the urine.1
Glycosuria
... which lowers plasma glucose, therefore reduces HbA1C1 and glucose toxicity2
... which causes a caloric loss, resulting in weight loss1,3 and reduction in fat mass1,4
Osmotic diuresis
… which reduces plasma volume, leading to reduction in blood pressure and cardiac preload1,5
Natriuresis
... which alters tubular-glomerular feedback and reduces glomerular hyperfiltration6
... which reduces arterial pressure,7 which improves cardiac afterload5
JARDIANCE® (empagliflozin) is a reversible, highly potent and selective competitive inhibitor of sodium-glucose cotransporter 2 (SGLT2).1
In addition to glucose lowering, JARDIANCE® (empagliflozin) demonstrated secondary benefits of reduction in weight and blood pressure although it is not licensed for this.
The effect of Jardiance (empagliflozin) on the CRM system are mediated via multiple mechanisms
SGLT2 inhibitors: mode of action18
Learn more
Safety Profile
Efficacy
Clinical trial
* EMPA-KIDNEY included patients with a wide range of underlying causes of CKD, many with co-morbidities across the spectrum of cardiovascular, kidney, or metabolic conditions. EMPA-KIDNEY included adult patients with an eGFR ≥20 to <45mL/min/1.73m2 or an eGFR ≥45 to <90mL/min/1.73m2 with a UACR ≥200mg/g, at risk of CKD progression.
Kidney disease progression defined as: adults with kidney function loss (sustained reduction of ≥40% eGFR decline, sustained eGFR <10mL/min/1.73m2), end stage kidney disease (initiation of chronic dialysis or kidney transplant), or renal death.
Abbreviations
CRM: cardio-renal-metabolic; CV: cardiovascular; CKD: chronic kidney disease; HbA1c: glycated haemoglobin; CVD: cardiovascular disease; LV: left ventricular; SGLT2is: sodium-glucose co-transporter-2 inhibitors; T2D: type 2 diabetes mellitus.
References
- JARDIANCE® (empagliflozin) Summary of Product Characteristics (SmPC). Available at: http://www.medicines.org.uk/emc/medicine/28973.
- Torimoto K et al. Diabetol Metab Syndr. 2017;9:60.
- Ferrannini G et al. Diabetes Care. 2015;38:1730–1735.
- Ridderstråle M et al. Lancet Diabetes Endocrinol. 2014;2:691–700.
- Garg V et al. Prog Cardiovasc Dis. 2019;62:349–357.
- Wanner C et al. N Engl J Med. 2016; 375:323–334.
- Chilton R et al. Diabetes Obes Metab. 2015;17:1180–1193.
- Heise T et al. Clin Ther 2016;38:2265-2276.
- Vallon V & Thomson SC. Diabetologia 2017;60:215-225.
- Verma S et al. Circulation 2019;140:1693-1702.
- Verma S et al. JAMA Cardiol 2017;2:939-940.
- Abdelgadir E et al. J Clin Med Res 2018;10:615-625.
- Rajasekeran H et al. Kidney Int 2016;89:524-526.
- Baartscheer A et al. Diabetologia 2017;60:568-573.
- Garg V et al. Prog Cardiovasc Dis 2019;62:349-357.
- Zinman B et al. N Engl J Med 2015;373:2117.
- Wanner C et al. N Engl J Med 2016;375:323.
- Kalra S. Diabetes Ther. 2014 Dec;5(2):355-66.
- Herrington WG, et al. N Engl J Med. 2023;388(2):117-127. (EMPA-KIDNEY results and the publication’s Supplementary Appendix).
PC-GB-108940 V2
March 2024