Type 2 Diabetes

Canagliflozin vs Sitagliptin for HbA1c in Diabetes Patients

Individuals with type 2 diabetes who use canagliflozin are more likely to reach their hemoglobin A1c (HbA1c) and weight loss goals, and to maintain HbA1c levels below their goal vs individuals who use sitagliptin, according to a recent study.

Findings from the study were presented on September 13, 2017, at the European Association for the Study of Diabetes (EASD) 53rd Annual Meeting 2017 in Lisbon, Portugal.
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Previous studies have suggested that canagliflozin is more beneficial to patients with type 2 diabetes vs sitagliptin.

To further compare the benefits associated with each treatment, the researchers evaluated data on patients with type 2 diabetes who had initiated canagliflozin (n = 14,165) or sitagliptin (n = 15,528) from March 29, 2012, to April 30, 2016. Patient data was obtained using the QuintilesIMS Real-World Data Electronic Medical Records US database. Baseline characteristics and HbA1c levels were similar between groups.

The researchers defined outcomes as HbA1c over time and time to reaching HbA1c goal (below 7%, below 8%, or below 9%), weight loss of 5% or more, failure to maintain HbA1c goal, adding or switching to a new antihyperglycemic agent, and the composite of failure to maintain HbA1c goal or adding or switching to a new antihyperglycemic agent.

Results indicated that post-index mean HbA1c had decreased in both groups. However, mean HbA1c was significantly lower in patients using canagliflozin compared with patients on sitagliptin at each interval up to 30 months, except at 21 months.

Patients on canagliflozin had been 12% to 15% more likely to reach HbA1c goals of below 7%, below 8%, or below 9%. They were also 47% more likely to lose 5% or more of their body weight vs patients on sitagliptin; were 31% less likely to add or switch to a new antihyperglycemic agent; and were 10% to 15% less likely to fail to maintain their HbA1c below 7%, below 8%, or below 9%.

“These findings suggest a higher durability of glycemic control in patients initiated on [canagliflozin] relative to [sitagliptin],” the researchers concluded.

—Christina Vogt

Reference:

Ingham M, Lefebvre P, Pilon D, et al. Glycaemic control, weight loss, and use of other antihyperglycaemics in patients with type 2 diabetes initiated on canagliflozin or sitagliptin: a real-world analysis. Paper presented at: European Association for the Study of Diabetes (EASD) 53rd Annual Meeting 2017; September 11-15, 2017. Lisbon, Portugal. http://www.abstractsonline.com/pp8/ - !/4294/presentation/5259. Accessed on September 18, 2017.