Glycaemic and weight-loss outcomes of graded doses of canagliflozin in type 2 diabetes — a real-world study

Abstract

Background. Costs are the most important cause of therapeutic non-compliance. Half canagliflozin (CANA)–300 tablet has lowest cost/mg among all CANA preparations; data are unavailable on efficacy of half CANA-300. This study evaluated weight loss and glycaemic outcomes of 100 mg versus 150 mg versus 300 mg of canagliflozin as part of standard therapy. Methods. Data, retrospectively captured from medical records of two centres in Delhi for patients > 35 years with type-2 diabetes (T2DM), and on canagliflozin, having > 6 months follow-up, were analysed. Patients were in 3-groups depending on canagliflozin dosage: Group 1 on canagliflozin 100 mg/day (1 tablet CANA-100), Group-2 on canagliflozin 150 mg/day (half tablet CANA-300), and Group 3 on canagliflozin 300 mg/day (1 tablet CANA-300). Primary endpoints were glycaemic efficacy and weight-loss. Results. From 3,569 records evaluated, 1,232 people with T2DM on canagliflozin were screened; data from 528 individuals analysed (257, 138 and 133 in Groups: 1, 2 and 3 respectively). People in all three groups were comparable with regards to sex, T2DM duration, glycated haemoglobin (HbA1c), haemoglobin, creatinine, lipids, albuminuria and medications. Group-2 patients were youngest and had highest BMI. Following 6-months, both absolute and percent weight-loss was significantly higher in Group-2 (–3.5 kg [–6.60–0.00]; –3.62%), followed by Group-3 (–3.0 kg [–5.3 to –0.8]; –3.33%), and lowest in Group-1 (–1.05 kg [–2.85 to –0.17]; –1.31%) (P = 0.002 and 0.014, respectively). Glycaemic efficacy was comparable among groups. Conclusion. Half CANA-300 tablet has comparable glycaemic efficacy and weight-loss compared to single CANA-300 tablet, but superior weight-loss compared to CANA-100.