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Canagliflozin improved glycemic control, decreased body weight
Glycemic control improvements and decreases in body weight were linked to canagliflozin when added to insulin therapy, according to recent study findings published in Diabetes Care.
Bruce Neal, PhD, of the University of Sydney and the Royal Prince Alfred Hospital in Australia, and colleagues of the CANVAS trial randomly assigned patients with type 2 diabetes receiving insulin to placebo (n=690), canagliflozin 100 mg (n=692) or canagliflozin 300 mg (n=690) to determine the safety, efficacy and effects of canagliflozin (Invokana, Janssen) on patients with type 2 diabetes using insulin. Researchers also examined changes in HbA1c from baseline to 18 and 52 weeks.
Rescue therapy was required during the first 18 weeks by 4% of each active treatment group and 8% of the placebo group.
Compared with placebo, patients in both active treatment groups had significantly reduced primary HbA1c levels at week 18 (P<.001); reductions were also seen at week 52. At week 18, patients in both active treatment groups had reduced body weight and fasting plasma glucose levels (all P<.001) and increases in patients achieving HbA1c <7% (all P<.001) compared with placebo. Similar effects were observed at 52 weeks.
HDL cholesterol levels were raised at weeks 18 and 52 in patients receiving 300 mg while they were raised only at 52 weeks in patients receiving 100 mg. LDL cholesterol levels were elevated at 18 and 52 weeks with both doses. Triglycerides were reduced only at 52 weeks in patients receiving 300 mg.
Younger patients vs. older patients (P=.02) and patients with more obesity vs. less obesity (P=.05) had greater effects on HbA1c. Compared with placebo, both treatment groups had reduced albuminuria.
Adverse events were reported for all treatment groups; however, the canagliflozin group was more likely to report events leading to discontinuation, genital mycotic infections and volume-related adverse events.
“In conclusion, canagliflozin appears to offer significant benefits when used in conjunction with insulin therapy,” the researchers wrote. “However, additional data are required for the subset of patients using insulin, and for patients with diabetes more broadly, to objectively define the effects of canagliflozin on major clinical outcomes.”
Disclosure: The CANVAS trial is funded by Janssen Research & Development LLC. See the study for a complete list of the researchers’ relevant financial disclosures.