Real-World Data Show Patients More Likely to Stick With Canagliflozin Than GLP-1s

The study of electronic medical records showed that patients on the SGLT2 inhibitor stayed on the medication longer, although both groups took the same amount of time to get their A1C below 8%.

Every doctor knows medication only works if people take it. And the bottom line is, more patients with type 2 diabetes (T2D) are willing to take canagliflozin than any of several glucagon-like peptide-1 (GLP-1) receptor agonists, according to a study presented this past weekend at the American Association of Clinical Endocrinologists’ 26th Annual Scientific & Clinical Congress, held in Austin, Texas.

Researchers compared Quintiles-IMS data taken from electronic medical records for 11,435 patients with T2D who started taking canagliflozin and 11,582 who started on one of several GLP-1 therapies (liraglutide, exenatide, dulaglutide, or albiglutide) from 2012 to 2016. The 2 groups were well-balanced for baseline characteristics and glycated hemoglobin (A1C).

While it took the 2 groups the same amount of time to bring their A1C below 8%, the group taking 300 mg of canagliflozin (the larger dose available), was 30% less likely to stop taking the medication, with a median time to discontinuation of 12.4 months for canagliflozin compared with 8.6 months for the GLP-1 therapies. The patients taking canagliflozin were 28% less likely to add another therapy or switch therapies, with the median time to a new therapy 21.3 months, compared with 15.3 months for the GLP-1 therapies.

Canagliflozin, a sodium glucose co-transporter-2 (SGLT2) inhibitor, is an oral medication, while GLP-1 therapies are injected either once a day or once a week. The main side effect associated with canagliflozin is urinary tract infections, while GLP-1 therapies are associated with nausea and diarrhea.

The SGLT2 inhibitor class works by targeting the protein that manages glucose reabsorption in the kidney, blocking this function and causing excess sugar to be expelled through the urine. Thus, the drug class also has a diuretic effect, and patients experience reduced blood pressure and lose a modest amount of weight.

“Because real-world data reflect everyday clinical practice, these results are particularly relevant for physicians to consider when evaluating how best to support their patients in reaching and maintaining treatment goals,” study investigator Carol Wysham, MD, of the Rockwood Clinic in Spokane, Washington, said in a statement.


Lefebvre P, Pilon D, Ingham M, et al. Real-world persistence and HbA1c goal attainment in patients with type 2 diabetes mellitus initiated on canagliflozin or a glucagon-like peptide-1 receptor agonist. Presented at the 26th annual Scientific & Clinical Congress of the American Association of Clinical Endocrinologists, Austin Texas. May 5, 2017. Abstract 290.