Empagliflozin vs Canagliflozin

#1

I see a lot of people going with empagliflozin over canagliflozin on the forum.

It seems to me that from a longevity standpoint canagliflozin has the advantage.

Is it being chosen specifically for the heart failure protection advantage?

In almost every other health metric canagliflozin seems better, plus canagliflozin has the effects on AMPK.

I’m interested to hear the reasoning.

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Canagliflozin - Another Top Longevity Drug
#2

My two cents:

  • Empagliflozin and dapagliflozin have a better safety profile than canagliflozin
  • Empagliflozin also seems to increase lifespan in rodents (Chinese paper, weaker than the ITP)
  • Dapagliflozin might as well, see debate: Canagliflozin - Another Top Longevity Drug - #1601 by A_User
  • Empa and dapa are approved for heart failure (and lower mortality), a typical disease of aging, while cana is not
  • There are hints in longitudinal studies that empa and dapa might be neuroprotective while cana is not
  • Mendelian randomization studies found that SGLT2 inhibition was causally associated with longevity in males (father’s attained age), so the type of SGLT2 inhibitor might not matter that much (although another MR found something similar for SGLT1 and in that case only canagliflozin significantly inhibits SGLT1).
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#3

Didn’t you link a study showing empagliflozin’s effects on mTORC1?

I think that one convinced me to switch.

#4

Those?

I don’t know if it’s exclusive to empagliflozin or a class property.

#5

Yes. Thanks for linking those. I used to believe only canagliflozin influenced mTORC1, but after seeing those and some other recent studies, I think empagliflozin is the best choice of SGLT2i.

#6

I would be surprised if the effect was specific to empagliflozin. But who knows…