#662

That is great, thx. Could you point to a key one or two.

@AlexKChen and others see the threads about the AgelessRx mini trial on halving Cana pills for longevity contexts

#663

This is one example.

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#664

Thanks

After the treatment for 24 weeks, the HbA1c level was decreased both in group A (from 7.5%±1.1% to 6.5%±0.8%) and in group B (from 7.6%±0.8% to 7.2%±0.5%). This pilot trial suggested the possibility of 10-mg every other day administration with empagliflozin for Japanese patients with type 2 diabetes mellitus.

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#665

I’m not much of an expert but 3 grams of chromium sound like a lot? Are you sure humans can tolerate that. I thought minerals are supposed to be taken in low doses.

#666

That’s 3 grams of Ceylon cinnamon + micrograms of chromium. :smile:

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#667

I learned the hard way that a urinalysis will show +1 or +2 glucose if you’re taking Empagliflozin. I was searching all over the internet about it and finally figured out what it was from

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#668

This shows greater effects when taken daily so I don’t see any reason to take it every other day.

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#669

I take 10mg Empa, 40mg Telm, and 5mg Nebivolol and have been for quite some time now.

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#670

UK biobank study (:warning: preprint :warning: ) suggesting that SGLT2i (cana, dapa, empa) extend lifespan: First report from Epiterna on the search for drugs that can extend human lifespan

Another paper confirming that empa and dapa are equivalent in T2D: Cardiovascular outcomes between dapagliflozin versus empagliflozin in patients with diabetes mellitus 2024

There was no significant difference between the dapagliflozin and empagliflozin groups in the risk of MACE (3.7% vs. 4.8%, hazard ratio [HR], 1.31; 95% confidence interval [CI], 0.73–2.35; p = 0.349)
Dapagliflozin and empagliflozin showed no significant difference of real‐world clinical cardiovascular outcomes in patients with DM over a 3‐year period.

image

(if you look at a longer period of time, could dapa be better than empa?)

A potential pro-longevity pathway: SGLT2i improves kidney senescence by down-regulating the expression of LTBP2 in SAMP8 mice 2024

Together, these results reveal dapagliflozin can delay natural kidney senescence in non-diabetes environment; the mechanism may be through regulating the role of LTBP2.

Two reviews of the class:

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#671

Once these start coming off patent I wonder if we will see a meaningful uptake in longevity circles and broader health optimizer world



 case is building in a nice way

Just wish we could see some rich MR data on longevity for SGLT2i

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#672

They’re already off-patent. But for whatever reason generics haven’t reached the market yet (despite approval in the US: Lupin Receives Tentative Approval for Empagliflozin Tablets - Lupin ).

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#673

I think that is - as the link says - just a tentative approval - and patent still has to expedite

See below for instance where there is tentative approval - but the FDA then lists patents going out to between Nov 2025 and others into 2034

Perhaps it’s only the Nov 2025 they have to wait for?

https://www.accessdata.fda.gov/drugsatfda_docs/appletter/2019/212358Orig1s000_TAltr.pdf

#674

Maybe. In the EU dapagliflozin is already approved as generic but I’ve never seen it: Dapagliflozin Viatris | European Medicines Agency

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#675

That second EU news piece seems similar, they just say:

”recommended granting approval”

Have we seen anything that actually is fully and completely approved

and not just tentatively or recommended

Or actually that is BOTH is approved by FDA, or EMA, etc AND has legal right to sell (not really regulated by medicine agency, but by the legal system/Justice Department).

They need both patent expirity and approval - it’s not enough for one

#676

I work in a pharmacy, I’ve never seen dapagliflozin as a generic. Only Forxiga. By the way, dapagliflozin is way more prescribed than empagliflozin :person_shrugging:

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#677

Yes it’s fully approved: Dapagliflozin Viatris | European Medicines Agency

Per Wikipedia:

A generic version of dapagliflozin was approved by the US FDA in February 2022,[61] but cannot be sold until October 2025.[62][63] A generic version was approved in Canada in May 2023.[64]
In January 2023, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) adopted a positive opinion, recommending the granting of a marketing authorization for a generic version of Forxiga, which has been authorized in the EU since November 2012.[65] Dapagliflozin Viatris was approved for medical used in the European Union in March 2023.[4]

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#678

In France? Globally empagliflozin is number one, especially in the US and in the UK. Forxiga (Dapagliflozin) left Korea a few months ago because of the competition and the end of its patent there: Astrazeneca to withdraw diabetes drug Forxiga from Korea | BioWorld

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#679

Yes in France! Where I work it is.

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#680

Thanks, so then I think we are back to that it does not look the patents have expired until October in EU and November in US?

#681

Well, they certainly have expired in India a long time ago. :laughing: :laughing:

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