This information is intended for US healthcare professionals to access current scientific information about J&J Innovative Medicine products. It is prepared by Medical Information and is not intended for promotional purposes, nor to provide medical advice.

Use of INVOKANA in Patients With a Solitary Kidney

Last Updated: 06/20/2023

SUMMARY  

  • The safety and efficacy of INVOKANAwas not evaluated in patients with a solitary kidney; however, patients with a solitary kidney were not excluded from phase 3 studies.
  • A case-report has been published involving a patient with a solitary kidney treated with INVOKANA.1
  • A case series related to sodium-glucose cotransporter-2 (SGLT2) inhibitors was identified during a literature search and has been included in the REFERENCES section for your review.2

CLINICAL DATA

  • Patients with renal disease requiring treatment with immunosuppressive therapy or patients with a history of dialysis or renal transplant were excluded from the INVOKANAphase 3 studies.3

CASE REPORT

Maraka et al (2020)1 reported the case of a 51-year-old female with a solitary kidney and T2DM receiving INVOKANA 300 mg once daily, metformin 1000 mg twice daily and liraglutide 1.8 mg daily. Perioperatively, she received dexamethasone 4 mg. The day after an elective abdominoplasty she experienced a presyncopal event and was diagnosed with euglycemic diabetic ketoacidosis (DKA) and acute kidney injury. INVOKANA was discontinued and treatment with intravenous fluids (IV) fluids and insulin was initiated per hospital protocol. Five days after INVOKANA discontinuation, the patient experienced a recurrent presyncopal event with euglycemic DKA. She was treated per hospital protocol leading to the resolution of euglycemic DKA with no further recurrence.

Literature Search

A literature search of MEDLINE®, EMBASE®, BIOSIS Previews®, DERWENT® (and/or other resources, including internal/external databases) was conducted on 16 June 2023.

References

1 Maraka S,  Kearns AE,  Kittah NEN, et al. Recurrent euglycemic diabetic ketoacidosis after discontinuation of sodium-glucose cotransporter 2 inhibitor. Diabetes Res Clin Pract. 2016;118:77-78.
2 Škrtić M,  Cherney DZI,  Sridhar VS, et al. SGLT2 inhibition in patients with type 2 diabetes mellitus post-nephrectomy: a single-center case series. Can J Kidney Health Dis. 2021;8:20543581211065528.
3 Invokana (canagliflozin) Tablets - Medical Review(s). Food and Drug Administration (FDA). Center for Drug Evaluation and Research (CDER); 2013. http://www.accessdata.fda.gov/drugsatfda_docs/nda/2013/204042Orig1s000TOC.cfm. Accessed May 31, 2013.