Real-world evaluation of Hba1c, blood pressure, and weight loss among patients with type 2 diabetes mellitus treated with canagliflozin: an analysis of electronic medical records from a network of hospitals in Florida.

Abstract

OBJECTIVE:

Clinical trials and real-world studies reported that canagliflozin (CANA) improved HbA1c, blood pressure (BP), and weight in patients with type 2 diabetes mellitus (T2DM). This study examines if previous results hold regionally and within specific patient sub-groups.

METHODS:

Adults with T2DM and ≥12 months of clinical activity before the first CANA prescription (index) were identified in electronic medical records (January 1, 2012-February 15, 2017) from a network of hospitals in Florida. Quality measures were described at baseline and 3, 6, 9, and 12 months post-index. Selected thresholds were HbA1c < 7%, BP < 140/90 mmHg, and weight loss ≥5%. Sub-groups included patients ≥65 years old, with African American race, with CANA dose increase, initiating CANA in an endocrinology setting, and initiating CANA in a primary care setting.

RESULTS:

Overall, 1,259 patients (mean age = 56.7 years; 51.2% female, 70.4% White) were identified. Among patients with a baseline HbA1c ≥ 7%, 16.1% had an HbA1c < 7% 3 months following CANA initiation, and the mean HbA1c decreased from 8.8% to 8.1%. Among patients with a baseline systolic BP ≥140 mmHg or diastolic BP ≥ 90 mmHg, 59.3% attained a systolic BP < 140 mmHg and 77.3% a diastolic BP < 90 mmHg after 3 months. HbA1c and BP responses were sustained through 12 months. The proportion of patients with a weight loss from baseline ≥5% increased from 17.0% at 3 months to 31.1% at 12 months. Consistent trends were observed for all sub-groups.

CONCLUSIONS:

In CANA-treated patients and patient sub-groups from a network of Florida hospitals, improvements in quality measures and response durability were similar to clinical trials and other real-world studies.

• Authors: Damon Tanton, Mei Sheng Duh, Marie-Hélène Lafeuille, Patrick Lefebvre, Dominic Pilon, Maryia Zhdanava, Bruno Emond, Doreen Inman, Robert A Bailey
• Journal: Current medical research and opinion (Curr Med Res Opin) Vol. 34 Issue 6 Pg. 1099-1115 (06 2018) ISSN: 1473-4877 [Electronic] England
• PMID: 29468896 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Glycated Hemoglobin A
• Hypoglycemic Agents
• Canagliflozin

Topics

• Blood Pressure (drug effects)
• Canagliflozin (therapeutic use)
• Diabetes Mellitus, Type 2 (drug therapy, epidemiology, physiopathology)
• Electronic Health Records (statistics & numerical data)
• Female
• Florida (epidemiology)
• Glycated Hemoglobin (analysis)
• Humans
• Hypoglycemic Agents (therapeutic use)
• Male
• Middle Aged
• Weight Loss (drug effects)