Short-term outcomes of patients with Type 2 diabetes mellitus treated with canagliflozin compared with sitagliptin in a real-world setting

• Published in: Singapore medical journal 2018-05, Vol.59 (5), p.251-256
• Main Authors: Shao, Yan Li, Yee, Kuan Hao, Koh, Seow Ken, Wong, Yip Fong, Yeoh, Lee Ying, Low, Serena, Sum, Chee Fang
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Blood Glucose - drug effects; Blood Pressure; Body Mass Index; Body Weight; Canagliflozin - administration & dosage; Diabetes Mellitus, Type 2 - drug therapy; Female; Glomerular Filtration Rate; Hemoglobins - analysis; Humans; Hypoglycemic Agents - administration & dosage; Least-Squares Analysis; Male; Middle Aged; Original; Osmosis; Retrospective Studies; Singapore; Sitagliptin Phosphate - administration & dosage; Systole; Treatment Outcome; Young Adult
• ISSN: 0037-5675
• DOI: 10.11622/smedj.2017095

We aimed to evaluate the effectiveness and safety of canagliflozin as compared to sitagliptin in a real-world setting among multiethnic patients with Type 2 diabetes mellitus (T2DM) in Singapore. This was a new-user, active-comparator, single-centre retrospective cohort study. Patients aged 18-69 years with T2DM and estimated glomerular filtration rate ≥ 60 mL/min/1.73 m were eligible for inclusion if they were initiated and maintained on a steady daily dose of canagliflozin 300 mg or sitagliptin 100 mg between 1 May and 31 December 2014, and followed up for 24 weeks. In total, 57 patients (canagliflozin 300 mg, n = 22; sitagliptin 100 mg, n = 35) were included. The baseline patient characteristics in the two groups were similar, with overall mean glycated haemoglobin (HbA1c) of 9.4% ± 1.4%. The use of canagliflozin 300 mg was associated with greater reductions in HbA1c (least squares [LS] mean change -1.6% vs. -0.4%; p < 0.001), body weight (LS mean change -3.0 kg vs. 0.2 kg; p < 0.001) and systolic blood pressure (LS mean change: -9.7 mmHg vs. 0.4 mmHg; p < 0.001), as compared with sitagliptin 100 mg. About half of the patients on canagliflozin 300 mg reported mild osmotic diuresis-related side effects that did not lead to drug discontinuation. Our findings suggest that canagliflozin was more effective than sitagliptin in reducing HbA1c, body weight and systolic blood pressure in patients with T2DM, although its use was associated with an increased incidence of mild osmotic diuresis-related side effects.