Short-term outcomes of patients with type 2 diabetes mellitus treated with canagliflozin compared with sitagliptin in a real-world setting.

INTRODUCTION We aimed to evaluate the effectiveness and safety of canagliflozin when compared to sitagliptin in a real-world setting among multiethnic patients with type 2 diabetes mellitus (T2DM) in Singapore. METHODS This was a new-user, active-comparator, single-centre retrospective cohort study. Patients aged 18-69 years with T2DM and estimated glomerular filtration rate ≥ 60 mL/min/1.73 m² were eligible if they were initiated and on steady daily dose of canagliflozin 300 mg or sitagliptin 100 mg and had 24 weeks of follow-up subsequently. RESULTS In total, 57 patients were included, with 22 patients in the canagliflozin 300 mg group and 35 patients in the sitagliptin 100 mg group. Baseline characteristics of patients in the two groups were similar, with an overall mean glycated haemoglobin (HbA1c) of 9.4% ± 1.4%. The use of canagliflozin 300 mg was associated with greater reduction in HbA1c (least squares [LS] mean change: -1.6% vs. -0.4%; p < 0.001), body weight (LS mean change: -3.0 kg vs. 0.2 kg; p < 0.001) and systolic blood pressure (LS mean change: -9.7 mmHg vs. 0.4 mmHg; p < 0.001) when compared with sitagliptin 100 mg. About half of the patients on canagliflozin 300 mg reported mild osmotic diuresis-related side effects that did not lead to any drug discontinuation. CONCLUSION Our observations suggest that among patients with T2DM, canagliflozin tends to be more effective than sitagliptin in reducing HbA1c, body weight and systolic blood pressure, but with increased incidence of mild osmotic diuresis-related side effects.