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Research Article
6 June 2019

Treatment patterns, glycemic control and bodyweight with canagliflozin 300 mg versus GLP1RAs in Type II diabetes patients

Abstract

Aim: Real-world effectiveness of canagliflozin 300 mg versus glucagon-like peptide-1 receptor agonists (GLP1RAs) was examined in patients with Type II diabetes. Patients & methods: Patients were selected from the Optum integrated database of administrative claims and electronic health record data (1 January 2013 to 31 March 2015). Results: Patients were less likely to discontinue (p < 0.0001) or switch (p = 0.0048), more likely to add-on treatment (p = 0.0314), and achieve HbA1c <8.0% (p = 0.0364) or weight loss ≥5% (p < 0.0001) with canagliflozin versus GLP1RAs over 9 months. Mean HbA1c was similar at 3-month intervals over 9 months with canagliflozin and GLP1RAs. Conclusion: Patients were less likely to discontinue or switch with canagliflozin than GLP1RA, and were more likely to add-on. Canagliflozin patients were more likely to achieve HbA1c <8.0% and weight loss ≥5% than GLP1RA patients.

Supplementary Material

File (supplementary_materials.docx)

References

1.
International Diabetes Federation. IDF Diabetes Atlas (8th Edition). International Diabetes Federation, Brussels, Belgium (2017).
2.
Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin. Diabetes 26(2), 77–82 (2008).
3.
Stratton IM, Adler AI, Neil HA et al. Association of glycaemia with macrovascular and microvascular complications of Type 2 diabetes (UKPDS 35): prospective observational study. BMJ 321(7258), 405–412 (2000).
4.
American Diabetes Association. Standards of medical care in diabetes – 2018. Diabetes Care 41(Suppl. 1), S1–S159 (2018).
5.
Garber AJ, Abrahamson MJ, Barzilay JI et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive Type 2 diabetes management algorithm – 2018 executive summary. Endocr. Pract. 24(1), 91–120 (2018).
6.
Fallon Health. 2018 Healthcare Effectiveness Data and Information Set (HEDIS®) measures (2018). www.fchp.org/providers/resources/hedis-measures.aspx
7.
Ali MK, Bullard KM, Saaddine JB, Cowie CC, Imperatore G, Gregg EW. Achievement of goals in U.S. diabetes care, 1999–2010. N. Engl. J. Med. 368(17), 1613–1624 (2013).
8.
Carls G, Huynh J, Tuttle E, Yee J, Edelman SV. Achievement of glycated hemoglobin goals in the US remains unchanged through 2014. Diabetes Ther. 8(4), 863–873 (2017).
9.
Pladevall M, Williams LK, Potts LA, Divine G, Xi H, Lafata JE. Clinical outcomes and adherence to medications measured by claims data in patients with diabetes. Diabetes Care 27(12), 2800–2805 (2004).
10.
Nagrebetsky A, Griffin S, Kinmonth AL, Sutton S, Craven A, Farmer A. Predictors of suboptimal glycaemic control in Type 2 diabetes patients: the role of medication adherence and body mass index in the relationship between glycaemia and age. Diabetes Res. Clin. Pract. 96(2), 119–128 (2012).
11.
Heerspink HJ, Perkins BA, Fitchett DH, Husain M, Cherney DZ. Sodium glucose cotransporter 2 inhibitors in the treatment of diabetes mellitus: cardiovascular and kidney effects, potential mechanisms, and clinical applications. Circulation 134(10), 752–772 (2016).
12.
Drucker DJ. The cardiovascular biology of glucagon-like peptide-1. Cell Metab. 24(1), 15–30 (2016).
13.
Vallon V. The mechanisms and therapeutic potential of SGLT2 inhibitors in diabetes mellitus. Ann. Rev. Med. 66, 255–270 (2015).
14.
Lee S, Lee DY. Glucagon-like peptide-1 and glucagon-like peptide-1 receptor agonists in the treatment of Type 2 diabetes. Ann. Pediatr. Endocrinol. Metab. 22(1), 15–26 (2017).
15.
Mearns ES, Sobieraj DM, White CM et al. Comparative efficacy and safety of antidiabetic drug regimens added to metformin monotherapy in patients with Type 2 diabetes: a network meta-analysis. PLoS ONE 10(4), e0125879 (2015).
16.
Taieb V, Pacou M, Schroeder M, Nielsen AT, Schubert A, Neslusan C. A network meta-analysis (NMA) to assess the longer-term relative efficacy of canagliflozin in patients with Type 2 diabetes inadequately controlled on metformin. Value Health 18(7), A598 (2015).
17.
Taieb V, Pacou M, Schroeder M, Nielsen AT, Neslusan C, Schubert A. Bayesian network meta-analysis (NMA) to assess the relative efficacy of canagliflozin in patients with Type 2 diabetes mellitus (T2DM) inadequately controlled with insulin. Value Health 18(7), A598 (2015).
18.
Van Sanden S, Diels J, Guillon P, Nielsen AT. Bayesian network meta-analysis to assess relative efficacy of canagliflozin versus glucagon-like peptide-1 receptor agonists in dual and triple therapy in patients with Type 2 diabetes mellitus. Value Health 18(3), A54 (2015).
19.
Zaccardi F, Webb DR, Htike ZZ, Youssef D, Khunti K, Davies MJ. Efficacy and safety of sodium-glucose cotransporter 2 inhibitors in Type 2 diabetes mellitus: systematic review and network meta-analysis. Diabetes Obes. Metab. 18(8), 783–794 (2016).
20.
INVOKANA® (canagliflozin) tablets, for oral use [package insert]. Janssen Pharmaceuticals, NJ, USA (2018).
21.
Buysman EK, Chow W, Henk HJ, Rupnow MF. Characteristics and outcomes of patients with Type 2 diabetes mellitus treated with canagliflozin: a real-world analysis. BMC Endocr. Disord. 15(1), 67 (2015).
22.
Optum. Real world health care experiences form over 150 million unique individuals since 1993 (2015). www.optum.com/content/dam/optum/resources/productSheets/5302_Data_Assets_Chart_Sheet_ISPOR.pdf
23.
Optum. Optum integrated data: bring precision to your investment decisions (2014). www.optum.com/content/dam/optum3/optum/en/resources/fact-sheets/Integrated-Data-product-sheet.pdf
24.
Wysham CH, Lefebvre P, Pilon D et al. Quality measure and weight loss assessment in patients with Type 2 diabetes mellitus treated with canagliflozin or dipeptidyl peptidase-4 inhibitors. BMC Endocr. Disord. 17(1), 32 (2017).
25.
Wysham CH, Pilon D, Ingham M et al. Quality goal attainment and maintenance in patients with Type II diabetes mellitus initiated on canagliflozin or a glucagon-like peptide-1 receptor agonist in an actual practice setting. Curr. Med. Res. Opin. 34(6), 1125–1133 (2018).
26.
Cai J, Wang Y, Baser O, Xie L, Chow W. Comparative persistence and adherence with newer anti-hyperglycemic agents to treat patients with Type 2 diabetes in the United States. J. Med. Econ. 19(12), 1175–1186 (2016).
27.
Cai J, Divino V, Burudpakdee C. Adherence and persistence in patients with Type 2 diabetes mellitus newly initiating canagliflozin, dapagliflozin, DPP-4 s, or GLP-1 s in the United States. Curr. Med. Res. Opin. 33(7), 1317–1328 (2017).
28.
Lefebvre P, Pilon D, Ingham M et al. Real-world persistence and HbA1c goal attainment in patients with Type II diabetes mellitus initiated on canagliflozin or a glucagon-like peptide-1 receptor agonist. Poster presented at: American Association of Clinical Endocrinologists 26th Annual Scientific & Clinical Congress. TX, USA, 3–7 May 2017.
29.
Wysham C, Pilon D, Ingham M et al. Glycemic control and treatment costs in patients with Type 2 diabetes mellitus initiated on canagliflozin 300 mg or a glucagon-like peptide-1 receptor agonist in a real-world setting. Poster presented at: 77th Scientific Sessions of the American Diabetes Association (ADA). CA, USA, 9–13 June 2017.
30.
Wysham C, Pilon D, Ingham M et al. Real-world HbA1c levels in the context of persistence, treatment progression, and durability of HbA1c control in patients with Type 2 diabetes mellitus initiated on canagliflozin or a glucagon-like peptide-1 receptor agonist. Poster presented at: 26th Annual Scientific and Clinical Congress of the American Association of Clinical Endocrinologists (AACE). TX, USA, 3–7 May 2017.
31.
Russell-Jones D, Khan R. Insulin-associated weight gain in diabetes – causes, effects and coping strategies. Diabetes Obes. Metab. 9(6), 799–812 (2007).
32.
Feldstein AC, Nichols GA, Smith DH et al. Weight change in diabetes and glycemic and blood pressure control. Diabetes Care 31(10), 1960–1965 (2008).
33.
Wing RR, Lang W, Wadden TA et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with Type 2 diabetes. Diabetes Care 34(7), 1481–1486 (2011).
34.
Traina S, Guthrie R, Slee A. The impact of weight loss on weight-related quality of life and health satisfaction: results from a trial comparing canagliflozin with sitagliptin in triple therapy among people with Type 2 diabetes. Postgrad. Med. 126(3), 7–15 (2014).
35.
Traina SB, Slee A, Woo S, Canovatchel W. The importance of weight change experiences for performance of diabetes self-care: a patient-centered approach to evaluating clinical outcomes in Type 2 diabetes. Diabetes Ther. 6(4), 611–625 (2015).
36.
Austin PC. Using the standardized difference to compare the prevalence of a binary variable between two groups in observational research. Commun. Stat. Simul. Comput. 38(6), 1228–1234 (2009).