Does Farxiga (dapagliflozin) cause weight loss?

From the Guidelines

Farxiga (dapagliflozin) can cause weight loss as a side effect, with patients typically losing about 2-5 pounds over time, as it works by causing the kidneys to remove excess glucose through urine, resulting in calorie loss. This weight loss effect is a beneficial secondary outcome of Farxiga's primary purpose of treating type 2 diabetes and reducing cardiovascular risk 1. The standard dose of Farxiga is 5-10 mg taken once daily in the morning, with the 10 mg dose showing slightly more weight loss effects.

Some key points to consider when using Farxiga for weight loss include:

• The weight loss is usually gradual and may continue for several months after starting treatment
• Patients should maintain proper hydration while taking Farxiga and be aware of potential side effects like genital yeast infections and urinary tract infections
• Any weight loss program should include healthy eating and regular physical activity for optimal results, even when taking medications that may assist with weight reduction
• The use of SGLT2 inhibitors, such as Farxiga, has been shown to reduce the risk of hospitalization for heart failure and improve heart failure-related outcomes, including hospitalization for heart failure and heart failure-related symptoms, in people with diabetes with preserved or reduced ejection fraction 1

It's also important to note that the mechanism of benefit from SGLT2 inhibitors, such as Farxiga, in heart failure with reduced ejection fraction (HFrEF) remains uncertain, but treatment with these agents leads to osmotic diuresis and natriuresis, decreases in arterial pressure and stiffness, and a shift to ketone-based myocardial metabolism 1.

Overall, the use of Farxiga for weight loss should be considered in the context of its primary purpose of treating type 2 diabetes and reducing cardiovascular risk, and patients should be closely monitored for potential side effects and benefits.

From the FDA Drug Label

Following the lead-in period, eligible patients were randomized to dapagliflozin 5 mg, dapagliflozin 10 mg, or placebo in addition to their current dose of metformin As add-on treatment to metformin, dapagliflozin 10 mg provided statistically significant improvements in HbA1c and FPG, and statistically significant reduction in body weight compared with placebo at Week 24 Dapagliflozin treatment led to a statistically significant mean reduction in body weight from baseline at Week 52 (LOCF) compared with a mean increase in body weight in the glipizide group. The combination treatment of dapagliflozin 10 mg plus metformin XR provided statistically significant improvements in HbA1c and FPG compared with either of the monotherapy treatments and statistically significant reduction in body weight compared with metformin XR alone The combination treatment of dapagliflozin 5 mg plus metformin XR provided statistically significant improvements in HbA1c and FPG compared with either of the monotherapy treatments and statistically significant reduction in body weight compared with metformin XR alone

Farxiga (dapagliflozin) is associated with weight loss.

• In clinical trials, dapagliflozin has been shown to cause a statistically significant reduction in body weight compared to placebo or other antidiabetic agents.
• The weight loss effect of dapagliflozin has been observed in various studies, including those in which it was used as an add-on therapy to metformin or as a monotherapy.
• The exact mechanism of weight loss with dapagliflozin is not fully understood, but it is thought to be related to its ability to increase glucose excretion in the urine, leading to a reduction in calorie intake and an increase in glucose production in the liver 2, 2.

From the Research

Farxiga and Weight Loss

• Farxiga (dapagliflozin) has been shown to reduce body weight in patients with type 2 diabetes mellitus (T2DM) 3, 4, 5, 6, 7.
• The reduction in body weight is thought to be due to the drug's mechanism of action, which involves increasing urinary glucose excretion and reducing renal glucose reabsorption 4, 5.
• Studies have consistently shown that dapagliflozin is associated with statistically significant reductions in body weight compared to placebo or active comparators 3, 4, 6.
• The weight loss effect of dapagliflozin is often accompanied by improvements in glycemic control, blood pressure, and lipid profiles 3, 4, 6, 7.
• A study published in 2022 found that dapagliflozin acutely improved kidney function in patients with T2DM, and also resulted in significant reductions in BMI and weight 6.

Mechanism of Weight Loss

• Dapagliflozin's mechanism of action involves inhibiting the sodium-glucose cotransporter-2 (SGLT2) in the kidneys, which leads to increased urinary glucose excretion and reduced renal glucose reabsorption 4, 5.
• This increase in urinary glucose excretion is thought to contribute to the weight loss effect of dapagliflozin, as it reduces the amount of glucose available for energy production and storage in the body 4, 5.
• Additionally, dapagliflozin has been shown to have a modest diuretic effect, which may also contribute to weight loss 5.

Clinical Implications

• The weight loss effect of dapagliflozin may be beneficial for patients with T2DM who are overweight or obese, as it may help improve glycemic control and reduce the risk of cardiovascular complications 3, 4, 7.
• However, patients should be monitored for potential adverse effects, such as genital and urinary tract infections, which are more common with dapagliflozin than with placebo 3, 4, 7.