Authors report theirs is the first real-world study comparing the 2 SGLT2 inhibitors.
A recently published study that compared patients with type 2 diabetes (T2D) taking the highest dose of canagliflozin (Invokana, Janssen) with those taking the highest dose of dapagliflozin (Farxiga, AstraZeneca) has found that those taking canagliflozin achieved better glycemic control, were less likely to stop taking the medication, and were less likely to switch to another drug.
The study, which appeared online April 20, 2018, in Current Medical Research and Opinion, is the first real-world study comparing the 2 sodium glucose co-transporter 2 (SGLT2) inhibitors, which received FDA approval in March 2013 (canagliflozin) and January 2014 (dapagliflozin) to treat patients with T2D. Janssen Scientific Affairs funded the study.
"Controlling blood glucose levels is central to diabetes treatment because it can reduce the risk of diabetes-related complications, such as kidney disease, retinopathy, and potentially cardiovascular disease," said Lawrence Blonde, MD, lead author of the study, in a statement. Blonde is the director of the Ochsner Diabetes Clinical Research Unit, Frank Riddick Diabetes Institute, in the Department of Endocrinology, Diabetes and Metabolism, Ochsner Medical Center, New Orleans, Louisiana.
“This first real-world analysis comparing SGLT2 [inhibitor] therapies in adults with type 2 diabetes showed that canagliflozin 300 mg each day allowed more patients to achieve blood glucose control [A1C <7%] than did a daily dose of dapagliflozin 10 mg,” Blonde said.
Researchers examined data from the Optum Clinformatics database, for patients making a first pharmacy claim for either a 300 mg dose of canagliflozin or a 10 mg dose of dapagliflozin. Data were examined from the period January 1, 2014, to September 30, 2016.
Of the more than 50,000 patients who started on at least 1 of the drugs during the period, 2546 met all the inclusion and exclusion criteria; from these, 558 patients who started on canagliflozin were matched with 558 who started on dapagliflozin. Patient data was compared at the start of treatment and at 6 months. Researchers found:
The authors acknowledge that claims data do not reveal reasons for discontinuation on the drugs, but wrote, “These findings suggest that treatment with canagliflozin 300 mg vs dapagliflozin 10 mg may help more patients with T2DM achieve glycemic control in the real world, which may ultimately lead to fewer diabetic complications and improved outcomes.”
Blonde L, Patel C, Bookhart B, et al. A real-world analysis of glycemic control among patients with type 2 diabetes treated with canagliflozin versus dapagliflozin. [published online April 20, 2018]. Curr Med Res Opin. doi: 10.1080/03007995.2018.1458709.