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Effects of canagliflozin on initiation of insulin and other antihyperglycaemic agents in the CANVAS Program

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posted on 27.07.2020, 14:50 by David R Matthews, Carol Wysham, Melanie Davies, April Slee, Maria Alba, Mary Lee, Vlado Perkovic, Kenneth W Mahaffey, Bruce Neal
This study compared initiation of insulin and other AHAs with canagliflozin versus placebo for participants with type 2 diabetes and a history/high risk of cardiovascular disease in the CANagliflozin cardioVascular Assessment Study (CANVAS) Program. After 1 year fewer participants treated with canagliflozin versus placebo initiated any AHA (7% vs 16%), insulin (3% vs 9%;) or any non‐insulin AHA (5% vs 12%; p <0.001 for all); overall AHA initiation rates increased over time but were consistently lower with canagliflozin compared with placebo. During the study, the likelihood of initiating insulin was 2.7 times lower for participants treated with canagliflozin compared with placebo (hazard ratio, 0.37; 95% CI: 0.31,0.43; p <0.001). The time difference between 10% of patients in the canagliflozin and placebo groups being initiated on insulin from the beginning of the trial was about two years. Time to initiation of other AHAs, including metformin, dipeptidyl peptidase‐4 inhibitors, glucagon‐like peptide‐1 receptor agonists and sulphonylureas, was also delayed for canagliflozin versus placebo (p <0.001 for each). Compared with placebo, canagliflozin delayed the need for initiation of other AHAs and delayed time to insulin therapy, an outcome that is important to many people with diabetes.

History

Citation

Diabetes, Obesity and Metabolism, 2020, https://doi.org/10.1111/dom.14143

Author affiliation

Diabetes Research Centre, College of Life Sciences

Version

AM (Accepted Manuscript)

Published in

Diabetes, Obesity and Metabolism

Publisher

Wiley

issn

1462-8902

eissn

1463-1326

Acceptance date

16/07/2020

Copyright date

2020

Available date

20/07/2021

Notes

Trial registration: ClinicalTrials.gov identifiers NCT01032629, NCT01989754.

Language

en

Publisher version

https://dom-pubs.onlinelibrary.wiley.com/doi/10.1111/dom.14143

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