Efficacy and safety of canagliflozin in insulin dysregulated horses: a 4-week multi-arm, double-blind, randomized, clinical trial.

Authors

Johan Bröjer, Siv Hanche-Olsen, Constanze Fintl, Elin Svonni, Ingunn Risnes Hellings, Cecilia Müller, Sanna Lindåse

Published in

Journal of veterinary internal medicine. Volume 40. Issue 3. May 04, 2026.

Abstract

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are promising drugs for treatment of hyperinsulinemia in insulin-dysregulated (ID) horses.
Compare short-term effects of the SGLT2 inhibitor canagliflozin versus placebo on glucose and insulin responses during an oral sugar test (OST) and a forage-based feed challenge test (FCT), and to assess adverse effects.
Forty-two privately owned severely ID horses.
Multi-center, randomized, double-blind, placebo-controlled, parallel-group study. Horses were allocated (1:1:1) to receive canagliflozin (0.6 or 1.2 mg/kg PO q24h) or placebo. The study included a 5-day baseline evaluation, a 4-week at-home double-blind treatment period, and a 5-day follow-up evaluation. During each clinical visit, an OST (day 3) and FCT (day 4) were performed to characterize glucose and insulin responses. Adverse effects were recorded. Data are presented as geometric least squares mean (95% CI).
Peak insulin concentrations (μIU/mL) during the OST and the FCT were lower after treatment with canagliflozin 0.6 and 1.2 mg/kg compared with placebo (P ≤ .01); OST: 122.0 (96.6-154.0) and 108.6 (85.6-137.8) vs 288.7 (227.1-366.9) and FCT: 78.3 (37.6-162.9) and 54.2 (25.7-114.5) vs 140.3 (68.5-287.3). Canagliflozin caused a dose-dependent increase in triglyceride concentrations (P ≤ .01). Post-treatment triglyceride concentrations were 0.5 (0.4-0.8), 1.3 (0.9-2.0), and 2.9 (1.9-4.4) mmol/L for placebo, 0.6 mg/kg, and 1.2 mg/kg groups, respectively.
Canagliflozin effectively decreases hyperinsulinemia in ID horses but induces a dose-dependent increase in triglyceride concentrations.

PMID:
42364139
Bibliographic data and abstract were imported from PubMed on 28 Jun 2026.

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