Canagliflozin compared with sitagliptin for patients with type 2 diabetes who do not have adequate glycemic control with metformin plus sulfonylurea

Schernthaner G, Gross JL, Rosenstock J, et al. Canagliflozin compared with sitagliptin for patients with type 2 diabetes who do not have adequate glycemic control with metformin plus sulfonylurea: a 52-week randomized trial. Diabetes Care. 2013;36(9):2508-2515.

Canagliflozin was shown to be noninferior to sitagliptin for A1C lowering in the CANTATA-D2 trial, a 52-week study which compared these antihyperglycemic agents as add-on therapy in patients with type 2 diabetes inadequately controlled with metformin plus sulfonylurea treatment.

Mean change in A1C from baseline to Week 52, the study's primary endpoint, was -1.03% in the canagliflozin group and -0.66% in the sitagliptin group. A significantly greater reduction in fasting plasma glucose (FPG) was seen with canagliflozin versus sitagliptin: mean change of -28.7 mg/dL vs -2.2 mg/dL (P<0.001).
 
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Slide12 - Cantata-D2 Canagliflozin Noninferior  Slide13 - Cantata-D2 Significantly Greater FPG  

Statistically significant reductions in weight and systolic blood pressure were also seen with canagliflozin treatment versus sitagliptin at 52 weeks. With regard to lipid values, larger increases in LDL-C and HDL-C were observed with canagliflozin treatment versus sitagliptin.

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Slide14 - Cantata-D2 Significantly Greater Weight  Slide15 - Cnatata-D2 Significant Reductions  Slide16 - Cantata-D2 Effect of Canagliflozin  

The overall incidence of adverse events in CANTATA-D2 was similar in the canagliflozin and sitagliptin groups. The incidence of urinary tract infections and hypoglycemia was also similar between groups. A higher rate of genetic mycotic infections and osmotic diuresis (polyuria) was seen among canagliflozin-treated patients.

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Slide17 - Cantata-D2 Adverse Events  

CANTATA-D2 was a randomized, double-blind, active-controlled, Phase III trial examining the efficacy and safety of canagliflozin versus sitagliptin. Subjects had A1C ≥7.0% to ≤10.5% and were randomized 1:1 to 300 mg canagliflozin once daily (n=378) or 100 mg sitagliptin once daily (n=378). Mean baseline A1C in the trial was 8.1%, and participants' mean type 2 diabetes duration was 9.6 years. Baseline FPG was 158.5 mg/dL in the canagliflozin group and 158.4 mg/dL in the sitagliptin group.  

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Slide11 - Cantata-D2 Design  

Canagliflozin and sitagliptin are not indicated for weight loss or antihypertensive or lipid-lowering treatment. One formulation of canagliflozin (INVOKANA™) has been FDA approved as of May 2013. 

CANTATA-D2=Canagliflozin Treatment and Trial Analysis—dipeptidyl-peptidase-4 inhibitor

 

Related content: 

Slide: SGLT2 Inhibitors for Treatment of Type 2 Diabetes 

Overview: Efficacy and safety of canagliflozin monotherapy in subjects with type 2 diabetes mellitus inadequately controlled with diet and exercise 

 

The pharmacologic agents discussed are approved for use in the United States by the U.S. Food and Drug Administration (FDA) unless otherwise noted. Consult individual prescribing information for approved uses outside of the United States. 

May 2013 

This overview was created by KnowledgePoint360 Group, LLC, and was not associated with funding via an educational grant or a promotional/commercial interest.  

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Last Modified: 3/23/2015