Glycaemic control, medication persistence better with canagliflozin vs sitagliptin
Use of canagliflozin in the treatment of type 2 diabetes mellitus (T2DM) leads to greater reductions in glycosylated haemoglobin (HbA1c) and improved medication persistence when compared with sitagliptin, according to a study.
Researchers used data from a US health care administrative database and identified adult T2DM patients who used either canagliflozin (n=3,993) or sitagliptin (n=12,153). They performed propensity score matching to control for baseline differences between the two patient groups, resulting in the inclusion of 1,472 patients per group.
Patients were aged 56 years on average, and more than 50 percent were men. Clinical characteristics were well balanced, with 428 patients in each group having HbA1c ≥7 percent.
Results revealed that the main outcomes of change in HbA1c and persistence with medication over a follow-up of 9 months after index date were better with canagliflozin than with sitagliptin.
Specifically, reductions in HbA1c were −0.93 in the canagliflozin group vs −0.57 percent in the sitagliptin group (p=0.004). The mean time from index date to follow-up HbA1c was similar (185.4 vs 184.3 days, respectively; p=0.802).
Fewer patients on canagliflozin discontinued their medication during follow-up (29.8 vs 41.5 percent in the sitagliptin group; p<0.001). The average days of persistence on index therapy was also longer in the canagliflozin group (152 vs 139 days; p<0.001).
The present data, which demonstrate the superiority of canagliflozin over sitagliptin in the treatment of T2DM, are in line with those reported in previous clinical trials. [Diabetologia 2013;56:2582–2592; Diabetes Care 2013;36:2508–2515; Postgraduate Med 2016;128:725–730]
Nevertheless, identifying the optimal diabetes treatment choice in routine practice necessitates more studies aimed at providing a better understanding of antihyperglycaemic treatment, HbA1c results and differences among patients in demographic/clinical characteristics, as well as persistence with treatment, researchers said.