Effects of canagliflozin on initiation of insulin and other antihyperglycaemic agents in the CANVAS Program |
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| Authors: | David R. Matthews DPhil Carol Wysham MD Melanie Davies CBE April Slee PhD Maria Alba MD Mary Lee MPH Vlado Perkovic MBBS Kenneth W. Mahaffey MD Bruce Neal MB |
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| Affiliation: | 1. Oxford Centre for Diabetes, Endocrinology and Metabolism and Harris Manchester College, University of Oxford, Oxford, UK;2. University of Washington, Spokane, Washington, USA;3. Diabetes Research Centre, University of Leicester, Leicester, UK;4. Axio Research, Seattle, Washington, USA;5. Janssen Research & Development, LLC, Raritan, New Jersey, USA;6. The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia;7. Stanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA |
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| Abstract: | ![]()
This study compared initiation of insulin and other antihyperglycaemic agents (AHAs) with canagliflozin versus placebo for participants with type 2 diabetes and a history/high risk of cardiovascular disease in the CANagliflozin cardioVascular Assessment Study (CANVAS) Program. After 1 year, fewer participants treated with canagliflozin versus placebo initiated any AHA (7% vs. 16%), insulin (3% vs. 9%) or any non-insulin AHA (5% vs. 12%) (P < .001 for all); overall AHA initiation rates increased over time but were consistently lower with canagliflozin compared with placebo. During the study, the likelihood of initiating insulin was 2.7 times lower for participants treated with canagliflozin compared with placebo (hazard ratio, 0.37; 95% CI: 0.31, 0.43; P < .001). The time difference between 10% of patients in the canagliflozin and placebo groups being initiated on insulin from the beginning of the trial was about 2 years. Time to initiation of other AHAs, including metformin, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists and sulphonylureas, was also delayed for canagliflozin versus placebo (P < .001 for each). Compared with placebo, canagliflozin delayed the need for initiation of other AHAs and delayed time to insulin therapy, an outcome that is important to many people with diabetes. |
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| Keywords: | antihyperglycaemic agent insulin SGLT2 inhibitor type 2 diabetes |
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