Ertugliflozin is the latest sodium-glucose co-transporter-2 (SGLT-2) inhibitor available in Australia. This medication helps to regulate blood glucose levels in type 2 diabetes by increasing urinary glucose excretion.
The following products containing ertugliflozin were added to the Pharmaceutical Benefits Scheme (PBS) on the 1st December 2018:
- Ertugliflozin (Steglatro®);
- Ertugliflozin + metformin (Segluromet®); and
- Ertugliflozin + sitagliptin (Steglujan®).
A randomised study assessing the safety and efficacy of ertugliflozin in patients with type 2 diabetes demonstrated significant improvements in glycaemic control at week 26. Patients receiving 5mg or 15mg ertugliflozin as monotherapy achieved a reduction in HbA1c (%) of 0.79 and 0.96 respectively, compared to an increase of 0.20 in the placebo group. Ertugliflozin is not PBS approved for monotherapy.
One of the most common adverse effects reported with ertugliflozin therapy are fungal infections of the genital tract. Ketoacidosis, including life-threatening cases, has been identified in patients taking other SGLT-2 inhibitors. Factors that may predispose a patient to ketoacidosis include insulin dose reduction, acute febrile illness, reduced caloric intake, and alcohol abuse. Like other medicines in this class, consideration may be given to withholding ertugliflozin in situations that increase the risk of ketoacidosis such as fasting prior to surgery.
- Steglatro® (ertugliflozin) Australian approved product information. Macquarie Park: Merck Sharp & Dohme. Approved October 2018.
- Traill R. Severe euglycaemic ketoacidosis with SGLT2 inhibitor use in the perioperative period. Australian and New Zealand College of Anaesthetists, 2018.