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EHR data: Invokana lowers HbA1c, BP in type 2 diabetes
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Patients with poorly controlled type 2 diabetes prescribed Invokana saw a decrease in HbA1c that remained stable over 1 year, according to an analysis of electronic health records.
In a retrospective, observational study designed to examine the efficacy of Invokana (canagliflozin, Janssen) since its approval in 2013, researchers found that patients prescribed the sodium-glucose cotransporter 2 inhibitor also experienced weight loss and a decrease in blood pressure.
“While the efficacy profile of [canagliflozin] has been studied in many clinical trials, evidence on the real-world use of [canagliflozin] is also emerging,” Patrick Lefebvre, MA, vice president of Groupe d’analyse in Montreal, and colleagues wrote. “This study aims at describing the clinical characteristics and glycemic control of a sample of patients with [type 2 diabetes] following approval of [canagliflozin] in a real-world setting.”
Lefebvre and colleagues analyzed data from 16,163 patients with type 2 diabetes, a prescription for canagliflozin (index date) and 12 months of clinical activity before the prescription, identified through IMS Health’s real-world data electronic medical records U.S. database (mean baseline age, 58.5 years; 47.9% women; 75.8% white). HbA1c, BP and weight were assessed at baseline and 3, 6, 9 and 12 months after the index date. Researchers observed patients for a mean of 5.4 months. Quality measures included an HbA1c less than 7%, less than 8% and greater than 9% (poor control), as well as BP less than 140/90 mm Hg and weight loss of at least 5%.
Within the cohort, 90.4% were prescribed at least one antihyperglycemic agent; 55.7% had at least three antihyperglycemic agents prescribed. At index date, 65.5% were prescribed 100 mg canagliflozin; 34.5% were prescribed 300 mg canagliflozin; average treatment duration was 156 days.
Among patients with baseline HbA1c of at least 7%, 21.2% achieved an HbA1c of 7% or less; 59.5% achieved an HbA1c of 8% or less; 82.4% achieved an HbA1c of 9% or less at 3 months, with the proportions remaining stable through 12 months.
Among patients with baseline systolic BP of at least 140 mm Hg and diastolic BP of at least 90 mm Hg, 60% and 75.6%, respectively, achieved systolic BP of 140 mm Hg or less and diastolic BP of 90 mm Hg or less at 3 months, with proportions remaining stable at 12 months.
Researchers observed at least 5% weight loss in 13.3% of patients at 3 months; proportion increased to 25.8% at 12 months.
“In the U.S. health care system, where achievement of quality measures in patients with [type 2 diabetes] impacts provider reimbursement, therapy with [canagliflozin] may be an effective therapeutic option for improving such measurements,” the researchers wrote.
The researchers noted that some patients in the cohort were also treated with other antihyperglycemics, antihypertensives and weight-loss medications during follow-up, which may have contributed to the outcome. – by Regina Schaffer
Disclosure: Janssen Scientific Affairs LLC funded this study. Employees of Janssen were involved in the study design, data collection, manuscript preparation and publication decisions.
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