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Canagliflozin: Pharmacokinetics, tolerability and glucose/insulin effects of supratherapeutic doses in healthy horses
Swedish Univ Agr Sci, Dept Anim Biosci, Uppsala, Sweden..
Swedish Univ Agr Sci, Dept Clin Sci, Uppsala, Sweden..
Swedish Univ Agr Sci, Dept Clin Sci, Uppsala, Sweden..
Norwegian Univ Life Sci, Dept Compan Anim Clin Sci, Oslo, Norway..
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2025 (English)In: The Veterinary Journal, ISSN 1090-0233, E-ISSN 1532-2971, Vol. 313, article id 106412Article in journal (Refereed) Published
Abstract [en]

Sodium-glucose co-transporter 2 inhibitors like canagliflozin (CFZ) have shown promise in preventing hyperinsulinemia-associated laminitis in horses, but data on pharmacokinetics, tolerability, and controlled studies are limited. This randomized, open-label, placebo-controlled, crossover study evaluated these aspects of CFZ treatment in eight healthy Standardbred mares. Each horse received single supratherapeutic oral doses of CFZ (1.8 mg/kg or 3.6 mg/kg) and placebo, with a two-week washout between treatments. A graded glucose infusion (GGI) was administered post-treatment to evaluate glucose and insulin responses. Plasma CFZ, glucose, insulin, urinary glucose, serum biochemistry, and urinalysis samples were collected over 72 h post-treatment. For CFZ 1.8 mg/kg, median Cmax was 2623 ng/mL, Tmax 2.2 h, and T1/2Z 21.8 h; for 3.6 mg/kg, Cmax was 4975 ng/mL, Tmax 2.8 h, and T1/2Z 23.0 h. The pharmacokinetics of CFZ displayed dose-proportionality across the two tested doses. Insulin and glucose responses to a GGI, measured by the area under the concentration-time curve (AUC), were similar between CFZ doses but significantly reduced compared to placebo (p < 0.001). Specifically, mean glucose AUC for CFZ treatments was approximately 14–15 % lower, and mean insulin AUC 22–29 % lower, than for placebo. For CFZ-treated horses, mean urinary glucose concentrations ranged from 277 to 347 mmol/L at 24, 48, and 72 h post-administration, with no significant differences between dose levels. No clinical signs of adverse effects were observed, although a significant increase in GLDH levels compared to placebo (p < 0.05) was observed with the CFZ 3.6 mg/kg dose.

Place, publisher, year, edition, pages
Elsevier, 2025. Vol. 313, article id 106412
Keywords [en]
SGLT2 inhibitor, Canagliflozin, Graded glucose infusion, Pharmacokinetics, Horse, Equine, laminitis
National Category
Pharmaceutical Sciences
Identifiers
URN: urn:nbn:se:uu:diva-569133DOI: 10.1016/j.tvjl.2025.106412ISI: 001583147300001PubMedID: 40759271Scopus ID: 2-s2.0-105012869366OAI: oai:DiVA.org:uu-569133DiVA, id: diva2:2005682
Available from: 2025-10-10 Created: 2025-10-10 Last updated: 2025-10-10Bibliographically approved

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Hedeland, MikaelBergquist, Jonas

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