From the Guidelines
Empagliflozin (Jardiance) is associated with weight loss, with most patients experiencing a modest reduction in body weight, typically 2-3% over time, as reported in the 2018 consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) 1.
Mechanism of Weight Loss
The weight loss effect of empagliflozin is attributed to its mechanism of action as an SGLT2 inhibitor, which enhances the urinary excretion of glucose, resulting in calorie loss. Additionally, the mild diuretic effect of empagliflozin contributes to initial weight reduction through fluid loss.
Clinical Evidence
The EMPA-REG OUTCOME trial, a randomized, double-blind study, demonstrated that empagliflozin reduced the composite outcome of MI, stroke, and cardiovascular death by 14% over a median follow-up of 3.1 years 1. While the primary focus of this trial was on cardiovascular outcomes, the weight loss effect of empagliflozin is a notable secondary benefit.
Key Considerations
- The standard dosing of empagliflozin is 10mg once daily, which can be increased to 25mg daily if needed for better glycemic control.
- Empagliflozin should not be used solely for weight management in people without diabetes or cardiovascular disease, as it is not FDA-approved for weight loss alone and carries potential side effects, including genital yeast infections, urinary tract infections, and volume depletion.
- The weight loss effect of empagliflozin typically plateaus after several months of treatment.
Summary of Benefits
- Modest weight loss, typically 2-3% of body weight over time
- Improved glycemic control
- Reduced cardiovascular risk
- Potential benefits for patients with established or high-risk cardiovascular disease
Important Safety Considerations
- Potential side effects, including genital yeast infections, urinary tract infections, and volume depletion
- Contraindications, such as severe renal impairment or hypovolemia
- Monitoring requirements, including regular assessment of renal function and volume status.
From the FDA Drug Label
Treatment with JARDIANCE 10 mg or 25 mg daily resulted in statistically significant reductions in HbA1c (p-value <0. 0001), FPG, and body weight compared with placebo JARDIANCE 10 mg or 25 mg daily also resulted in statistically significantly greater percent body weight reduction compared to placebo % change from baseline (adjusted mean)-1.8-1.4-0.1 % change from baseline (adjusted mean)-2.4-2.40.7 Difference from placebo (adjusted mean) (95% CI)-1.7d (-3.0, -0.5)-1.3e (-2.5, -0.0) Difference from placebo (adjusted mean) (95% CI)-3.0b (-4.4, -1.7)-3.0b (-4.4, -1. 6)
Yes, Empagliflozin (Jardiance) causes weight loss, as shown by statistically significant reductions in body weight compared to placebo in clinical trials 2.
- The weight loss was observed with both 10 mg and 25 mg daily doses.
- The percent body weight reduction compared to placebo was significant in all studies.