Canagliflozin: Pharmacokinetics, tolerability and glucose/insulin effects of supratherapeutic doses in healthy horsesShow others and affiliations
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
2025-10-102025-10-102025-10-10Bibliographically approved