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Efficacy and safety of canagliflozin compared with placebo in older patients with type 2 diabetes mellitus: a pooled analysis of clinical studies.

AbstractBACKGROUND:
Canagliflozin is a sodium glucose co-transporter 2 inhibitor developed for the treatment of patients with type 2 diabetes mellitus (T2DM). The efficacy and safety of canagliflozin were evaluated in patients with T2DM <65 and ≥65 years of age.
METHODS:
Pooled data from 4 randomised, placebo-controlled, 26-week, Phase 3 studies (N = 2,313) evaluating canagliflozin 100 and 300 mg were analysed by age: <65 years (n = 1,868; mean age, 52.8 years) or ≥65 years (n = 445; mean age, 69.3 years). Efficacy evaluations included change from baseline in glycaemic parameters and systolic blood pressure (BP), and percent change from baseline in body weight. Assessment of safety/tolerability included adverse event (AE) reports, incidence of documented hypoglycaemia, and percent change from baseline in fasting plasma lipids.
RESULTS:
Canagliflozin 100 and 300 mg reduced HbA1c and fasting plasma glucose relative to placebo in patients <65 and ≥65 years of age. Both canagliflozin doses reduced body weight and systolic BP relative to placebo in patients <65 and ≥65 years of age. Incidence of overall AEs was similar across all treatment groups in patients <65 and ≥65 years of age. Incidences of serious AEs and AE-related discontinuations were similar across all treatment groups in patients <65 years of age and higher with canagliflozin 100 mg than other groups in patients ≥65 years of age. As in patients <65 years of age, incidences of genital mycotic infections and osmotic diuresis-related AEs were higher with canagliflozin relative to placebo in those ≥65 years of age. Incidences of urinary tract infections (UTIs), renal-related AEs, AEs related to volume depletion, and documented hypoglycaemia episodes were similar across all treatment groups in patients ≥65 years of age; no notable trends were observed with canagliflozin 100 and 300 mg relative to placebo in these AEs among patients <65 years of age. Changes in lipid parameters with canagliflozin were similar in both age subsets.
CONCLUSIONS:
Canagliflozin improved glycaemic control, body weight, and systolic BP, and was generally well tolerated in older patients with T2DM.
TRIAL REGISTRATION:
ClinicalTrials.gov, NCT01081834; NCT01106677; NCT01106625; NCT01106690.
AuthorsAlan Sinclair, Bruce Bode, Stewart Harris, Ujjwala Vijapurkar, Cristiana Mayer, Albert Fung, Wayne Shaw, Keith Usiskin, Mehul Desai, Gary Meininger
JournalBMC endocrine disorders (BMC Endocr Disord) Vol. 14 Pg. 37 (Apr 18 2014) ISSN: 1472-6823 [Print] England
PMID24742013 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Glucosides
  • Thiophenes
  • Canagliflozin
Topics
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Canagliflozin
  • Clinical Trials, Phase III as Topic
  • Diabetes Mellitus, Type 2 (drug therapy)
  • Female
  • Glucosides (therapeutic use)
  • Humans
  • Male
  • Meta-Analysis as Topic
  • Middle Aged
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Thiophenes (therapeutic use)
  • Young Adult

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