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  • Writer's pictureDženita Omerkić Dautović, MSc

All You Need To Know About Brenzavvy A New Drug For Treatment of Type-2 Diabetes

Updated: Oct 21, 2023


What Is Brenzavvy (Bexagliflozin)? For What Is Used Brenzavvy (Bexagliflozin)?

Bexagliflozin (brand name: Brenzavvy) is a medication used to treat type 2 diabetes. It belongs to a class of drugs known as sodium-glucose cotransporter 2 (SGLT2) inhibitors.

SGLT2 inhibitors work by blocking the reabsorption of glucose by the kidneys, leading to increased glucose excretion in the urine. By reducing the amount of glucose in the bloodstream, bexagliflozin can help to lower blood sugar levels and improve glycemic control in people with type 2 diabetes. Bexagliflozin is typically taken once daily as a tablet and can be combined with other diabetes medications, including insulin and metformin [citation; citation]. The medication is part of a comprehensive treatment plan that may include dietary changes, physical activity, and other medications to manage type 2 diabetes and its associated health risks.


What Is Type 2 Diabetes?

Type 2 diabetes is a chronic metabolic disorder characterized by high blood sugar levels (glucose) due to the body's inability to use insulin properly. Insulin is a hormone that helps regulate blood sugar levels. Type 2 diabetes is often associated with lifestyle factors such as obesity, physical inactivity, and poor diet. The main symptoms of type 2 diabetes include increased thirst and urination, fatigue, blurred vision, and slow healing of cuts and bruises. Treatment usually involves lifestyle modifications, medication, and regular monitoring of blood sugar levels [citation].


Who Developed Brenzavvy?

Brenzavvy (bexagliflozin) was developed by TheracosBio. TheracosBio is a pharmaceutical company in Marlborough, Massachusetts, focused on developing and commercializing medicines for essential diseases [citation].


What Is the Mechanism of Action of Brenzavvy?

Bexagliflozin is a type of medication called a sodium-glucose cotransporter 2 (SGLT2) inhibitor. It works by blocking the reabsorption of glucose by the kidneys and increasing its excretion in the urine [citation].

When glucose levels in the blood are high, the kidneys usually reabsorb it and return it to the bloodstream. Bexagliflozin prevents this reabsorption, leading to increased excretion of glucose in the urine and reduced glucose levels in the bloodstream. This action mechanism helps lower blood sugar levels in people with type 2 diabetes [citation].

In addition, by lowering blood glucose levels, SGLT2 inhibitors like bexagliflozin can also reduce insulin resistance levels, improved glucose control, and weight loss [citation].


What Is a Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor?

SGLT2 inhibitor works by blocking sodium-glucose cotransporter 2 (SGLT2), a protein in the kidneys that helps the body reabsorb glucose (sugar) from the urine back into the bloodstream. By blocking SGLT2, these medications cause the body to excrete excess glucose in the urine, which helps lower blood sugar levels [citation; citation].

SGLT2 inhibitors are typically taken orally and are often prescribed alongside lifestyle modifications such as a healthy diet and exercise. Some examples of SGLT2 inhibitors include canagliflozin, dapagliflozin, empagliflozin, and of course bexagliflozin (Brenzavvy). In addition to their blood sugar-lowering effects, SGLT2 inhibitors have also been shown to reduce cardiovascular and kidney disease risk in people with type 2 diabetes [citation].


What Are the Key Advantages of Brenzavvy?

The key advantages of Brenzavvy include the following:

  1. It lowers blood sugar levels by increasing the excretion of glucose in the urine in people with type 2 diabetes.

  2. It promotes weight loss as it helps to reduce glucose levels and insulin resistance.

  3. It improves overall glucose control in people with type 2 diabetes by reducing glucose levels and insulin resistance.

  4. It reduces the risk of cardiovascular events in people with type 2 diabetes.

  5. There is no risk of hypoglycemia compared to other diabetes medications that can cause low blood sugar levels (hypoglycemia). Brenzavvy does not have this risk, as it increases the excretion of glucose in the urine rather than directly affecting insulin levels [citation].


What Are the Key Warnings and Precautions of Brenzavvy?

Brenzavvy, like all medications, can cause side effects. Some of the most common side effects of bexagliflozin include

  1. Ketoacidosis. Reports of ketoacidosis [check here what ketoacidosis is] have been identified in clinical trials and postmarketing surveillance in patients with type 1 and type 2 diabetes mellitus who received SGLT2 inhibitors, including Brenzavvy.

  2. Lower limb amputation. There is an increased incidence of lower limb amputations occurred in Brenzavvy-treated patients compared to placebo-treated patients (8.3 versus 5.1 events per 1,000 patient-years) in a randomized, placebo-controlled trial evaluating patients with type 2 diabetes who had either established cardiovascular disease (CVD) or were at risk for CVD.

  3. Brenzavvy can cause volume depletion [check here what volume depletion is] through intravascular volume contraction, which may sometimes manifest as symptomatic hypotension or acute transient changes in creatinine.

  4. Urosepsis and pyelonephritis. There have been reports of severe urinary tract infections, including urosepsis and pyelonephritis [check here what pyelonephritis is] , requiring hospitalization in patients receiving SGLT2 inhibitors, including Brenzavvy.

  5. Hypoglycemia with concomitant use of insulin and insulin secretagogues. Insulin and insulin secretagogues [check here what secretagogues insulin is] (e.g., sulfonylureas) are known to cause hypoglycemia. Brenzavvy may increase the risk of hypoglycemia when combined with insulin and/or an insulin secretagogue.

  6. Necrotizing fasciitis of the perineum (Fournier’s Gangrene). Reports of necrotizing fasciitis of the perineum (Fournier’s Gangrene) [check here what necrotizing fasciitis is], a rare but severe and life-threatening necrotizing infection requiring urgent surgical intervention, have been identified in postmarketing surveillance in patients with diabetes mellitus receiving SGLT2 inhibitors.

  7. Genital Mycotic Infections. Brenzavvy increases the risk of genital mycotic infections. Patients who have a history of genital mycotic infections or who are uncircumcised are more likely to develop genital mycotic infections. Monitor and treat appropriately [citation].

Please check the following documentation for a more detailed overview of all warnings, precautions, and adverse effects related to Brenzavvy.


Additional Material


What Is Ketoacidosis?

Ketoacidosis is a severe medical condition that occurs when the body produces high levels of ketones, which are acidic molecules produced during the breakdown of fats for energy without sufficient glucose. Left untreated, it can lead to life-threatening complications such as coma and organ failure, most commonly associated with uncontrolled diabetes. Symptoms may include excessive thirst, frequent urination, nausea, vomiting, abdominal pain, confusion, fruity-smelling breath, and difficulty breathing. Treatment typically involves hospitalization and close monitoring.


What Is Volume Depletion?

Volume depletion is a medical condition that occurs when the body loses too much fluid and electrolytes, essential for adequately functioning the body's cells and organs. This can lead to a decrease in blood volume and blood pressure, which can cause symptoms such as dizziness, lightheadedness, and fainting. Volume depletion can occur due to various factors, including excessive sweating, vomiting, diarrhea, kidney disease, and certain medications. Treatment typically involves replacing lost fluids and electrolytes through oral or intravenous rehydration and addressing the underlying cause of the depletion.


What Is Urosepsis?

Urosepsis is a severe bacterial infection that occurs when a urinary tract infection (UTI) spreads to the bloodstream, leading to sepsis, a potentially life-threatening condition. Urosepsis can occur when bacteria from the urinary tract enter the bloodstream and spread throughout the body, causing widespread inflammation and organ damage [citation]. It is known that early sepsis is often not recognized in everyday clinical practice [citation].

Symptoms of urosepsis may include fever, chills, rapid heartbeat, low blood pressure, confusion, and difficulty breathing. Treatment typically involves hospitalization, intravenous antibiotics to control the infection, and supportive care to address organ dysfunction or fluid imbalances. Early diagnosis and prompt treatment are critical to improving outcomes and reducing the risk of complications [citation].


What Is Pyelonephritis?

Pyelonephritis is a type of urinary tract infection (UTI) that affects one or both kidneys. It occurs when bacteria enter the kidneys from the urinary tract, leading to inflammation and potential damage. Pyelonephritis can cause symptoms such as fever, chills, back or side pain, frequent and painful urination, and nausea or vomiting [citation].

Pyelonephritis can be acute, which means it comes on suddenly and severely, or chronic, which means it is a long-term condition that may recur over time. It is typically diagnosed through physical examination, laboratory tests, and imaging studies. Treatment involves antibiotics to control the infection and supportive care to manage symptoms and promote healing. Pyelonephritis can lead to untreated kidney damage and other serious complications [citation].


What Are Insulin Secretagogues?

Insulin secretagogues are a medication widely used to treat type 2 diabetes. They work by stimulating the release of insulin from the beta cells of the pancreas, which helps lower blood sugar levels. There are two main types of insulin secretagogues: sulfonylureas and meglitinides [citation].

Sulfonylureas work by binding to and stimulating insulin release from the beta cells of the pancreas. They include medications such as glipizide, glyburide, and glimepiride. Meglitinides work similarly but have a faster onset and shorter duration of action. They include medications such as repaglinide and nateglinide [citation]. Sulfonylureas are not combined with meglitinides, but there is an option for combination with other medications. Their combination is not recommended because they have a similar mechanism of action [citation].

Insulin secretagogues are typically taken orally and are often prescribed alongside lifestyle modifications such as a healthy diet and exercise [citation]. Side effects may include low blood sugar levels (hypoglycemia), weight gain, and gastrointestinal symptoms. Therefore, they are generally not recommended for use in people with type 1 diabetes [citation].


What Is Necrotizing Fasciitis?

Necrotizing fasciitis, also known as "flesh-eating disease," is a rare but serious bacterial infection affecting the skin, subcutaneous tissue, and fascia (the connective tissue surrounding muscles, nerves, and blood vessels). It can spread rapidly, cause tissue death (necrosis) and damage surrounding organs and tissues [citation].

Symptoms of necrotizing fasciitis may include severe pain, swelling, redness, and warmth in the affected area, as well as fever, nausea, vomiting, and confusion. The infection can quickly progress to life-threatening sepsis [citation].

Necrotizing fasciitis is a medical emergency and requires immediate treatment, typically with antibiotics and surgery, to remove dead tissue and control the spread of the infection. Therefore, early diagnosis and prompt treatment are critical to reducing the risk of complications and improving outcomes [citation].


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