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

Shao, Yan Li; Yee, Kuan Hao; Koh, Seow Ken; Wong, Y; Yeoh, Lee Ying; Low, Sui Pheng; Sum, Chee Fang

doi:10.11622/smedj.2017095

Cited by 4 publications

(4 citation statements)

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“…Finally only five articles [ 9 – 13 ] were confirmed and included in this meta-analysis as shown in Fig. 1 .…”

Section: Resultsmentioning

confidence: 99%

“…of patients treated with 300 mg CANA ( n ) No. of patients treated with sitagliptin 100 mg ( n ) Types of study Background drugs Lavalle-González [ 9 ] 368 367 366 RCT Metformin monotherapy Rodbard [ 10 ] 108 – 108 RCT Metformin and sitagliptin Rosenstock [ 11 ] 64 64 65 RCT Metformin Schernthaner [ 12 ] – 377 378 RCT Metformin + sulfonylurea Shao [ 13 ] – 22 35 Retrospective cohort – Total no. of patients ( n ) 540 830 952 CANA canagliflozin, RCT randomized controlled trials …”

Section: Resultsmentioning

confidence: 99%

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Adverse Drug Events Associated with sitagliptin Versus canagliflozin for the Treatment of Patients with Type 2 Diabetes Mellitus: A Systematic Comparison Through a Meta-Analysis

Bundhun

Huang

2018

Diabetes Ther

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IntroductionIn this meta-analysis, we aimed to systematically compare the adverse drug events associated with sitagliptin (100 mg) versus canagliflozin 100 or 300 mg in patients who were treated for type 2 diabetes mellitus (T2DM).MethodsOnline databases were searched for relevant studies comparing sitagliptin (100 mg) versus canagliflozin. Adverse drug events were considered as the clinical endpoints. The analysis was carried out by RevMan software whereby risk ratios (RR) and 95% confidence intervals (CI) were generated.ResultsFive studies with a total number of 2322 patients were included. When sitagliptin (100 mg) was compared with canagliflozin (100 mg), the endpoints of any adverse events, adverse events leading to drug discontinuation, serious adverse events, urinary tract infections, hypoglycemia, and adverse events related to hypovolemia were not significantly different: (RR 1.10, 95% CI 1.00–1.21; P = 0.05), (RR 1.20, 95% CI 0.67–2.16; P = 0.54), (RR 0.90, 95% CI 0.49–1.66; P = 0.73), (RR 1.26, 95% CI 0.77–2.08; P = 0.36), (RR 1.01, 95% CI 0.30–3.43; P = 0.99), and (RR 1.76, 95% CI 0.52–5.94; P = 0.36), respectively. However, canagliflozin was associated with increased genital mycotic infection (RR 4.32, 95% CI 2.11–8.83; P = 0.0001). When genital mycotic infections associated with sitagliptin versus canagliflozin were compared in male and female patients separately, the risk was still significantly higher with canagliflozin: (RR 7.00, 95% CI 2.44–20.06; P = 0.003) and (RR 4.02, 95% CI 2.22–7.27; P = 0.00001), respectively. The same results were obtained when sitagliptin (100 mg) was compared to canagliflozin 300 mg.ConclusionsCanagliflozin was associated with a significantly higher risk of genital mycotic infections when compared to sitagliptin. However, the other adverse drug events were similarly manifested when sitagliptin 100 mg was compared to either canagliflozin 100 or 300 mg.

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“…Finally only five articles [ 9 – 13 ] were confirmed and included in this meta-analysis as shown in Fig. 1 .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Adverse Drug Events Associated with sitagliptin Versus canagliflozin for the Treatment of Patients with Type 2 Diabetes Mellitus: A Systematic Comparison Through a Meta-Analysis

Bundhun

Huang

2018

Diabetes Ther

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“…Our findings are consistent with other real-world studies and clinical trials showing SGLT2 inhibitor initiation to be associated with a higher likelihood of achieving HbA1c targets compared to DPP4 inhibitor initiation (40.8% vs. 37.5%). Locally, a single-centre retrospective cohort study of 57 patients also reported that patients on canagliflozin were more likely to attain HbA1c levels below 7% than patients in the sitagliptin group (13.6% vs. 8.6%) at 24-week follow-up [ 18 ]. Another prospective Canadian registry study assessing outcomes associated with canagliflozin observed that more patients achieved HbA1c below 7% over time, reaching 38.8% by 12 months [ 25 ] which is similar to our findings of 40.8% up to one year follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…It remains unclear if the use of SGLT2 inhibitors in the local context is associated with the desired outcomes shown in clinical trials, while real-world studies comparing SGLT2 inhibitors with DPP4 inhibitors were mainly done in the western countries. To date, only a small local retrospective cohort study of 57 patients compared the effects of canagliflozin and sitagliptin on glycaemic control [ 18 ]. Given ethnicity is a significant predictor of HbA1c levels, local evidence is needed to assess the real-world effectiveness of these newer drug classes in specific ethnic subgroups and the Singapore general population [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Real-world evaluation of sodium-glucose co-transporter-2 inhibitors and dipeptidyl peptidase-4 inhibitors for managing type 2 diabetes mellitus: a retrospective multi-ethnic cohort study

Goh

Sun

Ong

et al. 2022

J Diabetes Metab Disord

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Purpose Sodium-glucose co-transporter-2 (SGLT2) inhibitors and dipeptidyl peptidase-4 (DPP4) inhibitors are increasingly used as second-line therapies in patients with type 2 diabetes. The aim of this study was to assess the real-world effects of SGLT2 inhibitors in a multi-ethnic population in Singapore. Methods This retrospective cohort study examined patients diagnosed with and treated for diabetes from the Ministry of Health’s administrative database. Differences in outcomes between treatment groups were assessed using Poisson regression. Demographics, clinical characteristics, previous diagnoses and hospitalisations, and diabetes medication history were used for propensity score matching. Subgroup analyses by ethnicity were performed. Effect size was estimated using risk ratios (RRs) with 95% confidence intervals (CIs). Results Patients initiating SGLT2 inhibitors were more likely to achieve glycaemic control target than DPP4 inhibitor-treated patients (RR 1.09; 95% CI 1.04, 1.14). This was observed only in patients of Chinese ethnicity. A higher risk of diabetic ketoacidosis in SGLT2 inhibitor initiators was not observed. SGLT2 inhibitors were associated with reduced risk of hypoglycaemia (RR 0.69; 95% CI 0.59, 0.82) and urinary tract infection (RR 0.52; 95% CI 0.43, 0.63) but was not statistically significant for hypoglycaemia in Malay patients. Compared to DPP4 inhibitors, SGLT2 inhibitors were associated with 12% and 34% reduction in any-cause hospitalisation and all-cause mortality, respectively, potentially resulting in more than $50 million savings over 10 years. Conclusion SGLT2 inhibitors were associated with improvements in glycaemic control, reduced risk of complications, and was well tolerated. Ethnicity also plays a role and should be considered in future studies.

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Canagliflozin

2018

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

Abstract: Introduction:We aimed to evaluate the effectiveness and safety of canagliflozin when

Cited by 4 publications

References 25 publications

Adverse Drug Events Associated with sitagliptin Versus canagliflozin for the Treatment of Patients with Type 2 Diabetes Mellitus: A Systematic Comparison Through a Meta-Analysis

Adverse Drug Events Associated with sitagliptin Versus canagliflozin for the Treatment of Patients with Type 2 Diabetes Mellitus: A Systematic Comparison Through a Meta-Analysis

Real-world evaluation of sodium-glucose co-transporter-2 inhibitors and dipeptidyl peptidase-4 inhibitors for managing type 2 diabetes mellitus: a retrospective multi-ethnic cohort study

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