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2015 ; 15
(ä): 67
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Characteristics and outcomes of patients with type 2 diabetes mellitus treated
with canagliflozin: a real-world analysis
#MMPMID26527413
Buysman EK
; Chow W
; Henk HJ
; Rupnow MF
BMC Endocr Disord
2015[Nov]; 15
(ä): 67
PMID26527413
show ga
BACKGROUND: Canagliflozin, an oral agent that inhibits sodium glucose
co-transporter 2, improves glycemic control, body weight, and blood pressure and
is generally well tolerated in patients with type 2 diabetes mellitus (T2DM).
This study extends the scope of previous analyses by evaluating outcomes
associated with the use of canagliflozin over a 6-month period in a real-world
setting. METHODS: This retrospective cohort study used data obtained from a large
health plan database for patients (?18 years) with a diagnosis of T2DM who filled
at least one canagliflozin prescription between April 1, 2013 and October 30,
2013 (first 7 months canagliflozin was commercially available in the USA) and
were continuously enrolled in the health plan for 6 months prior to (baseline)
and 6 months following the first canagliflozin prescription claim (follow-up).
Changes in glycemic control were evaluated, along with characteristics of
enrolled patients and changes in treatment patterns. RESULTS: 4017 patients (mean
age 56 years, 43 % female) met the study inclusion criteria. Of these, at the
time of first canagliflozin claim, 21 % used canagliflozin concomitantly with
three or more other antihyperglycemic agents (AHAs), 29 % with two other AHAs,
30 % with one other AHA, and 20 % without other AHAs. During follow-up, patients
received 3.4 (average) canagliflozin prescription fills and a mean of 148 total
days of supply; median adherence (interquartile range [IQR]) was 86 % (66-98 %)
for patients with ?2 fills. Among patients with available glycated hemoglobin
(A1C) measurements at baseline and follow-up (n?=?826, baseline A1C 8.59 %), mean
A1C reduction was 0.81 % (P?0.001). Mean A1C reduction during the follow-up
period was greatest in patients with the highest baseline A1C levels. Of the
patients who used canagliflozin concomitantly with other AHAs, 20 % were observed
to discontinue one or more other AHAs during follow-up. The most commonly
discontinued baseline AHAs were: glucagon-like peptide-1 receptor agonists
(16 %), dipeptidyl peptidase-4 inhibitors (15 %), insulin (13 %), sulfonylureas
(13 %), and metformin (11 %). CONCLUSIONS: This real-world study on canagliflozin
use in a range of patients with T2DM demonstrated significant improvements in
mean A1C from baseline following the first canagliflozin prescription. In
patients concomitantly using one or more additional AHAs at baseline, there
appears to be a trend toward lower other AHA use after canagliflozin initiation.
|Blood Glucose/*drug effects
[MESH]
|Canagliflozin/*therapeutic use
[MESH]
|Diabetes Mellitus, Type 2/blood/*drug therapy/epidemiology
[MESH]