A comprehensive review of the efficacy and safety of ertugliflozin

Ertugliflozin is the fourth sodium-glucose co-transporter (SGLT2) inhibitor approved by the US FDA in 2017 for the treatment of type 2 diabetes mellitus. The main purpose of this review is to evaluate the clinical efficacy and safety of ertugliflozin. We conducted a search of relevant literature on ertugliflozin in the PubMed and Web of Science databases up to 22 October 2024. Ertugliflozin reduces the incidence of composite renal endpoints, maintain eGFR, and decreases urine albumin to creatinine ratio. Cardiovascular effects of ertugliflozin are primarily demonstrated in the VERTIS CV trial. However, the cardiovascular benefits of ertugliflozin are inferior to those of empagliflozin or canagliflozin. Ertugliflozin had non-significant impact on major adverse cardiovascular events, cardiovascular death, or hospitalization for heart failure (HHF); ertugliflozin did reduce the risk of HHF, including in elderly population. Notably, ertugliflozin did not significantly reduce NT-proBNP levels in heart failure patients, while it decreased the incidence of persistent ventricular tachycardia or ventricular fibrillation events. Ertugliflozin may be beneficial for ocular diseases or neurodegenerative diseases. Adverse events associated with ertugliflozin are similar to those of previously approved SGLT2 inhibitors, although it is associated with a higher overall risk of cancer, especially renal cancer.