Introduction: While several sodium glucose co-transporter 2 (SGLT2) inhibitors are approved as an adjunct to diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus (T2DM), there are no clinical trial data providing head-to-head comparisons of the efficacy and safety of these therapies. Real-world analyses can provide valuable evidence on the effectiveness of competing treatments. This study compared the real-world glycemic effectiveness of SGLT2 inhibitors in individuals with T2DM.
Methods: Patients who initiated canagliflozin 300 mg versus empagliflozin 25 mg or dapagliflozin 10 mg were identified from the Optum® De-identified Clinformatics® Extended Data Mart-Date of Death database and propensity score matched. Achievement of HbA1c < 8.0% (Healthcare Effectiveness Data and Information Set [HEDIS] target) and > 9.0% (HEDIS poor control) after 6 months of treatment was calculated.
Results: Post-baseline HbA1c was similar in the canagliflozin and empagliflozin cohorts (7.65% versus 7.57%), as was percent of patients with HbA1c < 8.0% or > 9.0%. Post-baseline HbA1c was lower with canagliflozin versus dapagliflozin (7.58% versus 7.74%; P = 0.0247). The canagliflozin cohort was more likely to achieve HbA1c < 8.0% than the dapagliflozin cohort (P = 0.0292); the likelihood of achieving HbA1c > 9.0% was similar.
Conclusion: In patients with T2DM, HbA1c outcomes were similar with canagliflozin and empagliflozin. Patients on canagliflozin versus dapagliflozin were more likely to have a lower HbA1c and reach HbA1c < 8.0% after 6 months. These results may provide important information for clinicians as they decide the appropriate treatment for their patients with T2DM.
Keywords: Canagliflozin; Dapagliflozin; Empagliflozin; Glycated hemoglobin; Glycemic efficacy; Type 2 diabetes mellitus.