SGLT2 Inhibitors Canagliflozin, Dapagliflozin Compared in Real-World Study

Real-world study compares sodium glucose cotransporter 2 Inhibitor (SGLT2i) treatments
Real-world study compares sodium glucose cotransporter 2 Inhibitor (SGLT2i) treatments

A study published in Current Medical Research and Opinion compared the real-world efficacy of two sodium-glucose co-transporter 2 (SGLT2) inhibitors, canagliflozin (Invokana; Janssen) and dapagliflozin (Farxiga; AstraZeneca), on HbA1c reduction in patients with type 2 diabetes. 

Researchers performed a retrospective cohort study by identifying patients from the Optum Clinformatics database who were initiated on canagliflozin 300mg or dapagliflozin 10mg from January 1, 2014 to September 30, 2016. The primary outcome was the proportion of patients with HbA1c <8.0% (Healthcare Effectiveness Data and Information Set [HEDIS] target). Secondary outcomes included the proportion of patients with HbA1c <7.0% (American Diabetes Association [ADA] target) and >9.0% (HEDIS poor control) as well as absolute change in HbA1c and treatment patterns.

The results showed that at 6 months a significantly greater proportion of patients in the canagliflozin arm achieved HbA1c <8.0% vs patients in the dapagliflozin arm (70.8% vs 59.1%; odds ratio [OR] 1.60; P =.0001). In addition, a significantly greater proportion of patients achieved HbA1c <7.0% in the canagliflozin vs dapagliflozin arm (36.7% vs 25.15; OR 1.75; P <.0001). The authors noted a similar proportion of patients having HEDIS poor control in both treatment arms (12.0% vs 15.1%; OR 0.77; P =.1386).

A greater mean HbA1c reduction was seen with canagliflozin vs dapagliflozin (-1.17% vs -0.91%; treatment difference -0.26%; P =.0049). Moreover, patients treated with canagliflozin exhibited a lower likelihood of treatment discontinuation vs dapagliflozin (OR 0.75, 95% CI: 0.57, 0.99; P .0400) or medication switch (OR 0.72, 95% CI: 0.54 0.96; P =.0229). In addition, canagliflozin-treated patients were less likely to require add-on therapy (OR 1.30, 95% CI: 0.96, 1.74; P =.0865). 

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"This first real-world analysis comparing SGLT2i therapies in adults with type 2 diabetes showed that canagliflozin  300mg each day allowed more patients to achieve blood glucose control [A1C <7%] than did a daily dose of dapagliflozin 10mg," stated study author Lawrence Blonde, MD, Director, Ochsner Diabetes Clinical Research Unit, Frank Riddick Diabetes Institute, Department of Endocrinology, Diabetes and Metabolism, Ochsner Medical Center, New Orleans, LA.

Canagliflozin is available as 100mg and 300mg strength tablets and dapagliflozin is available as 5mg and 10mg strength tablets.

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