Efficacy and safety of canagliflozin when used in conjunction with incretin‐mimetic therapy in patients with type 2 diabetes
Open accessAbstract
Aims To assess the efficacy and safety of canagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, in patients with type 2 diabetes enrolled in the CANagliflozin cardioVascular Assessment Study (CANVAS) who were on an incretin mimetic [dipeptidyl peptidase-4 (DPP-4) inhibitor or glucagon-like peptide-1 (GLP-1) receptor agonist]. Methods CANVAS is a double-blind, placebo-controlled study that randomized participants to canagliflozin 100 or 300 mg or placebo added to routine therapy. The present post hoc analysis assessed the efficacy and safety of canagliflozin 100 and 300 mg compared with placebo in subsets of patients from CANVAS who were taking background DPP-4 inhibitors or GLP-1 receptor agonists with or without other antihyperglycaemic agents at week 18. Results Of the 4330 patients in CANVAS, 316 were taking DPP-4 inhibitors and 95 were taking GLP-1 receptor agonists. At 18 weeks, canagliflozin 100 and 300 mg provided larger placebo-subtracted reductions in glycated haemoglobin (HbA1c) in patients taking DPP-4 inhibitors [-0.56% (95% confidence interval [CI]: -0.77, -0.35), and -0.75% (95% CI: -0.95, -0.54), respectively] and GLP-1 receptor agonists [-1.00% (95% CI: -1.35, -0.65), and -1.06% (95% CI: -1.43, -0.69), respectively]. Body weight and blood pressure (BP) reductions were seen with canagliflozin versus placebo in both subsets. Higher incidences of genital mycotic infections and osmotic diuresis-related adverse events (AEs) were seen with canagliflozi…
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Several smaller short-term trials reported additive effects of GLP-1 receptor agonists and SGLT2 inhibitors on surrogate outcomes such as body weight, blood pressure and HbA1c.
“Several smaller short-term trials reported additive effects of GLP-1 RAs and SGLT2i on surrogate outcomes such as body weight, blood pressure and HbA1c18–21.”
From Effects of semaglutide with and without concomitant SGLT2 inhibitor use in participants with type 2 diabetes and chronic kidney disease in the FLOW trial (2024) · cites this paper as [18]
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- Authors
- Fulcher, G., Matthews, D. R., Perkovic, V., de Zeeuw, D., Mahaffey, K. W., Mathieu, C., Woo, V., Wysham, C., Capuano, G., Desai, M., Shaw, W., Vercruysse, F., Meininger, G., Neal, B., & on behalf of the CANVAS trial collaborative group
- Affiliations
- The University of Sydney (AU)
- Oxford Centre for Diabetes, Endocrinology and Metabolism (GB)
- Department of Clinical Pharmacy and Pharmacology University Medical Centre Groningen, University of Groningen Groningen The Netherlands
- Stanford Medicine (US)
- KU Leuven (BE)
- University of Manitoba (CA)
- Washington State University Spokane (US)
- Janssen Research & Development (United States) (US)
- Janssen (Belgium) (BE)
- Corresponding author
- Fulcher, G.
- ORCID
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2015-12-08
- Volume
- 18
- Issue
- 1
- Pages
- 82-91
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- OpenAlex
- W1920830047
- Cited by
- 91
- References
- 0
- Citations by year
- 2026: 1 · 2025: 5 · 2024: 8 · 2023: 2 · 2022: 7 · 2021: 10 · 2020: 7 · 2019: 7 · 2018: 16 · 2017: 13 · 2016: 14
- FWCI
- 12.44
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Diabetes Obesity and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- Own your potential (DEAKIN) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Research Portal (King's College London) (submittedVersion)
- Lirias (KU Leuven) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- Janssen Research and Development
- Medtronic
- Novo Nordisk
- Sanofi-Aventis Korea Company
- Eli Lilly and Company
- Novartis
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- SGLT2 inhibitors, type 2 diabetes, DPP-4 inhibitors, GLP-1 receptor agonists, HbA1c, HbA1c reduction, hypoglycemia, genital mycotic infections, osmotic diuresis, weight loss
- MeSH terms
- Canagliflozin, Sodium-Glucose Transporter 2 Inhibitors, Glucagon-Like Peptide-1 Receptor Agonists, Aged, Blood Pressure, Diabetes Mellitus, Type 2, Double-Blind Method, Drug Therapy, Combination, Female, Glycated Hemoglobin, Humans, Hypoglycemia, Hypoglycemic Agents, Male, Middle Aged, Urologic Diseases, Weight Loss, Biomimetics, Incretins, Dipeptidyl-Peptidase IV Inhibitors
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