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
Current Medical Research and Opinion. 2018 Jun;34(6):1125-1133
To compare achievement of quality goals (HbA1c, weight loss/body mass index [BMI], systolic blood pressure [SBP]), including maintaining HbA1c, between patients with type 2 diabetes mellitus (T2DM) treated with canagliflozin 300 mg (CANA) or a GLP-1 in an actualpractice setting.
Adults with T2DM newly initiated on CANA or a GLP-1 were identified from the IQVIATM Real-World Data Electronic Medical Records-US database (2012Q2-2016Q1). To account for differences in baseline characteristics, inverse probability of treatment weighting was used. Outcomes were compared using Cox models (hazard ratios [HRs] and 95% confidence intervals [CIs]) and Kaplan-Meier analyses.
CANA (n = 11,435) and GLP-1 (n = 11,582) cohorts had similar attainment of HbA1c < 8.0% (64 mmol mol) and hba1c >< 9.0% (75 mmol mol; hba1c >< 8.0%: hr [ci] =" 0.98" [0.91-1.06]; hba1c >< 9.0%: hr [ci] =" 1.02" [0.93-1.12]), while glp-1 patients were 10% more likely to achieve hba1c >< 7.0% (53 mmol mol). cana and glp-1 patients were similar in maintaining hba1c >< 7.0%, >< 8.0%, or><9.0%, achieving weight loss ≥5% (hr [ci] =" 1.05" [0.99-1.12]), achieving bmi><30 kg m2 (hr [ci] =" 1.11" [0.98-1.27]), and achieving sbp><140 mmhg (hr [ci] =" 1.07" [0.98-1.17]). cana patients were 30% less likely to discontinue treatment, 28% less likely to have a prescription for a new anti-hyperglycemic, and 17-21% less likely to fail to maintain hba1c >< 8.0% or 9.0% or have a prescription for a new anti-hyperglycemic (composite outcome) vs glp-1. no significant difference was observed for the composite outcome using the hba1c >< 7.0% threshold.> 7.0%> 8.0%>140 mmhg>30 kg>9.0%,> 8.0%,> 7.0%, > 7.0%> 9.0%:> 8.0%:> 9.0%> 8.0%>
This retrospective study in an actual practice setting showed that CANA patients were generally as likely as GLP-1 patientsto achieve HbA1c, weight, and blood pressure thresholds, and to maintain glycemic control while being less likely to discontinue treatment and/or have a new anti-hyperglycemic prescribed.