Evaluation of: Cefalu WT, Leiter LA, Yoon KH et al. Efficacy and safety of
canagliflozin versus
glimepiride in patients with
Type 2 diabetes inadequately controlled with
metformin (CANTATA-SU): 52-week results from a randomized, double-blind, Phase III non-inferiority trial. Lancet 382, 941-950 (2013). The CANTATA-SU study compared two doses of the
sodium glucose cotransporter 2 inhibitor
canagliflozin (CANA 100 and 300 mg) with the sulfonylurea,
glimepiride (6-8 mg) in
Type 2 diabetes mellitus patients inadequately controlled on
metformin, over 52 weeks.
Glimepiride reduced the mean baseline HbA1C from 7.8-6.99%. CANA 100 mg reduced the baseline HbA1C from 7.8-6.98% and CANA 300 mg reduced HbA1C from 7.8-6.87%. Fasting plasma
glucose was lowered to a greater extent following CANA 100 mg (1.3 mmol/l) and CANA 300 mg (1.52 mmol/l) as compared to
glimepiride (1.02 mmol/l). CANA 100 and 300 mg reduced
body weight by 3.7 and 4.0 kg, respectively compared to a 0.7 kg increase with
glimepiride. Blood pressure was modestly reduced by both CANA treatments. Both
high-density lipoprotein and
low-density lipoprotein cholesterol were increased by both doses of CANA compared to
glimepiride. Documented
hypoglycemia was lower with CANA, but
polyuria, pollakiuria, genital mycotic and
urinary tract infections were significantly greater in both doses of CANA compared to
glimepiride.