Characteristics and short-term outcomes of patients with type 2 diabetes mellitus treated with canagliflozin in a real-world setting

Abstract

Objective:

Canagliflozin is a sodium glucose co-transporter 2 inhibitor that has been shown to improve glycemic control in type 2 diabetes mellitus (T2DM). This study aimed to describe the characteristics, treatment utilization, and outcomes of patients treated with canagliflozin in the real world within the first 6 months of it being commercially available.

Methods:

This retrospective cohort study used a large US health plan database for commercial and Medicare Advantage enrollees. Patients aged 18 and over with T2DM who filled a canagliflozin prescription during 1 April 2013 to 30 September 2013 were eligible for inclusion. Patients were required to be enrolled for 6 months before (baseline period) and 3 months after (follow-up period) the first canagliflozin claim.

Results:

Overall, 3234 patients met study criteria (mean age was 55.7 years; 43.4% were female). Among patients with available lab data at baseline and follow-up, mean HbA1c decreased from 8.54% at baseline to 7.76% at follow-up (p < 0.001); the proportion of patients with HbA1c ≥9.0% decreased by more than half (from 32.0% at baseline to 15.5% at follow-up, p < 0.001). Almost all (94.8%) patients received at least one baseline antihyperglycemic agent; among them, 33.6% received two and 41.5% received three or more agents. Compared to baseline, usage of antihyperglycemic agents during follow-up was lower for metformin, sulfonylureas, insulin, DPP-4 inhibitors, GLP-1 receptor agonists and thiazolidinediones.

Conclusions:

Patients treated with canagliflozin when first available in the US typically had poorly controlled HbA1c levels at baseline and had received multiple prior antihyperglycemic agents. Following the first canagliflozin claim, they had an improvement in HbA1c levels and used fewer antihyperglycemic agents. These study results should help clinicians and payers better understand the initial profile of patients receiving canagliflozin and short-term outcomes in the real world. Given the short follow-up time frame and the fact that HbA1c data was not available in all patients, future research on longer term outcomes is warranted.

Keywords: :

• Canagliflozin
• Diabetes
• HbA1c levels
• Real-world
• Treatment patterns

Transparency

Declaration of funding

This study was supported by Janssen Scientific Affairs LLC.

Declaration of financial/other relationships

H.J.H. and E.K.B. have disclosed that they are employees of Optum, a consulting firm retained by Janssen to conduct the study on which this manuscript is based. W.C. and M.F.T.R. have disclosed that they are employees of Janssen Scientific Affairs, LLC.

CMRO peer reviewers on this manuscript have received an honorarium from CMRO for their review work, but have no relevant financial or other relationships to disclose.

Acknowledgments

Jesse Potash (Optum) provided medical writing assistance. Randall Gerdes (Optum) and Feng Cao (Optum) provided programming support.