Abstract
The observational Real-Wecan study showed that canagliflozin 100 mg (CANA100) as an add-on therapy, and canagliflozin 300 (CANA300), switching from prior SGLT-2i therapy, significantly improved several cardiometabolic parameters in patients with T2DM. The aim of this sub-analysis was to assess the effectiveness and safety of canagliflozin in patients aged ≥65 years. The primary outcome of the study was the mean change in HbA1c over the follow-up period. A total of 583 patients met the inclusion criteria (39.5% ≥65 years), 279 in the cohort of CANA100 (36.9% ≥65 years; mean HbA1c 8.05%) and 304 in the cohort of CANA300 (mean age 61.1 years; 41.8% ≥65 years; mean HbA1c 7.51%). In the CANA100 cohort, older patients showed significant reductions in HbA1c (−0.78%) and weight (−4.5 kg). Patients aged ≥65 years switching to CANA300 experienced a significant decrease in HbA1c (−0.27%) and weight (−2.1 kg). There were no significant differences in HbA1c and weight reductions when the cohorts of patients <65 and ≥65 years were compared in a multiple linear regression model. The safety profile of canagliflozin was similar in both age groups. These findings support canagliflozin as an effective therapeutic option for older adults with T2DM.
Highlights
Diabetes, type 2 diabetes mellitus (T2DM), is becoming more prevalent in the general population, especially in individuals over the age of 65 years
We have previously studied in a real-world setting the effectiveness of canagliflozin 100 mg (CANA100) and the switch to canagliflozin 300 (CANA300) from prior SGLT-2is in patients with T2DM [17]
The Real-Wecan study is a multicentric retrospective study whose aims were to assess in a real-world setting the effectiveness and safety of canagliflozin 100 mg/d (CANA100) as an add-on to the background antihyperglycaemic agents (AHA), and to evaluate the intensification of prior SGLT-2i therapy by switching to canagliflozin 300 mg/d (CANA300) in patients with T2DM
Summary
Type 2 diabetes mellitus (T2DM), is becoming more prevalent in the general population, especially in individuals over the age of 65 years. Canagliflozin is one of the new therapies introduced in T2DM treatment in the last years. It belongs to the sodium–glucose co-transporter type 2 inhibitors (SGLT-2is) class of AHA drugs that reduce tubular reabsorption of filtered glucose, inducing urinary glucose excretion in individuals with hyperglycaemia, which leads to decreased plasma glucose as well as an osmotic diuresis and net caloric loss [6,7,8,9]. In phase 3 studies, canagliflozin has been shown, in patients with T2DM, to improve glycaemic control and reduce body weight and blood pressure (BP) in combination with different AHA therapies [10,11,12,13,14]. Canagliflozin has demonstrated cardiovascular (CV) and renal benefits in patients with T2DM and high CV risk or chronic kidney disease (CKD) [15,16]
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