NICE recommends Janssen’s Invokana


Janssen's new diabetes treatment Invokana has received an initial recommendation from NICE.

The good news for Janssen has coincided with its launch across the UK, where it will go head-to-head with a number of other new diabetes treatments.

Canagliflozin is an oral, once-daily medication belonging to the new class of drug called sodium glucose co-transporter (SGLT-2) inhibitors. It works by blocking the reabsorption of glucose in the kidneys which is instead passed out of the body in the urine.

NICE has already approved Forxiga (dapagliflozin) AstraZeneca and BMS' drug in the same class. The Institute gave Forxiga the thumbs up in May 2013 after having initially rejected it on cost-effectiveness grounds.

Meanwhile several other molecules in the same class are in late stage development - Boehringer Ingelheim and Lilly's empagliflozin and Sanofi and Kowa's tofogliflozin.

Invokana (canagliflozin) can be used in combination with other diabetes drugs, including insulin, for the treatment of type 2 diabetes.

A competitive market

However the drug will have to jostle for space in the crowded diabetes market, where there are lots of more established treatments.

For instance, NICE has recommended Invokana in a dual therapy regimen with metformin only if:

• the person is at significant risk of hypoglycaemia or its consequences or

• a sulfonylurea is contraindicated or not tolerated.


Professor Carole Longson, Director, Centre for Health Technology Evaluation at NICE said: "Type 2 diabetes can be difficult to treat and most people will eventually require a number of drugs, often used simultaneously. Canagliflozin represents a useful addition to the armoury of anti-diabetic drugs available to clinicians. NICE is therefore pleased to be able to recommend its use for some people with type 2 diabetes."


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