Cardiovascular outcomes associated with canagliflozin versus other non-gliflozin antidiabetic drugs: Population based cohort study

144Citations
Citations of this article
173Readers
Mendeley users who have this article in their library.

Abstract

Objective To evaluate the cardiovascular safety of canagliflozin, a sodium-glucose cotransporter 2 inhibitor for the treatment of type 2 diabetes mellitus, in direct comparisons with DPP-4 inhibitors (DPP-4i), GLP-1 receptor agonists (GLP-1RA), or sulfonylureas, as used in routine practice. Design Population based retrospective cohort study. Setting Nationwide sample of patients with type 2 diabetes from a large de-identified US commercial healthcare database (Optum Clinformatics Datamart). Participants Three pairwise 1:1 propensity score matched cohorts of patients with type 2 diabetes 18 years and older who initiated canagliflozin or a comparator non-gliflozin antidiabetic agent (ie, a DPP-4i, a GLP-1RA, or a sulfonylurea) between April 2013 and September 2015. Main outcome measures The primary outcomes were heart failure admission to hospital and a composite cardiovascular endpoint (comprised of being admitted to hospital for acute myocardial infarction, ischemic stroke, or hemorrhagic stroke). Hazard ratios and 95% confidence intervals were estimated in each propensity score matched cohort controlling for more than 100 baseline characteristics. Results During a 30 month period, the hazard ratio for heart failure admission to hospital associated with canagliflozin was 0.70 (95% confidence interval 0.54 to 0.92) versus a DPP-4i (n=17 667 pairs), 0.61 (0.47 to 0.78) versus a GLP-1RA (20 539), and 0.51 (0.38 to 0.67) versus a sulfonylurea (17 354). The hazard ratio for the composite cardiovascular endpoint associated with canagliflozin was 0.89 (0.68 to 1.17) versus a DPP-4i, 1.03 (0.79 to 1.35) versus a GLP-1RA, and 0.86 (0.65 to 1.13) versus a sulfonylurea. Results were similar in sensitivity analyses further adjusting for baseline hemoglobin A1c levels and in subgroups of patients with and without prior cardiovascular disease or heart failure. Conclusions In this large cohort study, canagliflozin was associated with a lower risk of heart failure admission to hospital and with a similar risk of myocardial infarction or stroke in direct comparisons with three different classes of non-gliflozin diabetes treatment alternatives as used in routine care.

References Powered by Scopus

Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)

19793Citations
N/AReaders
Get full text

Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes

9122Citations
N/AReaders
Get full text

Effects of intensive glucose lowering in type 2 diabetes

6978Citations
N/AReaders
Get full text

Cited by Powered by Scopus

Comprehensive Management of Cardiovascular Risk Factors for Adults with Type 2 Diabetes: A Scientific Statement from the American Heart Association

281Citations
N/AReaders
Get full text

2018 ACC Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes and Atherosclerotic Cardiovascular Disease: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways

254Citations
N/AReaders
Get full text

Empagliflozin and the Risk of Heart Failure Hospitalization in Routine Clinical Care: A First Analysis from the EMPRISE Study

173Citations
N/AReaders
Get full text

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Cite

CITATION STYLE

APA

Patorno, E., Goldfine, A. B., Schneeweiss, S., Everett, B. M., Glynn, R. J., Liu, J., & Kim, S. C. (2018). Cardiovascular outcomes associated with canagliflozin versus other non-gliflozin antidiabetic drugs: Population based cohort study. BMJ (Online), 360. https://doi.org/10.1136/bmj.k119

Readers' Seniority

Tooltip

PhD / Post grad / Masters / Doc 53

63%

Researcher 19

23%

Professor / Associate Prof. 11

13%

Lecturer / Post doc 1

1%

Readers' Discipline

Tooltip

Medicine and Dentistry 72

77%

Pharmacology, Toxicology and Pharmaceut... 14

15%

Nursing and Health Professions 5

5%

Social Sciences 3

3%

Article Metrics

Tooltip
Mentions
News Mentions: 4
Social Media
Shares, Likes & Comments: 4

Save time finding and organizing research with Mendeley

Sign up for free