Canagliflozin versus sitagliptin in type 2 diabetes

The aim of this study was to compare blood sugar control and weight loss in patients with type 2 diabetes (T2D) who were treated with canagliflozin compared to sitagliptin. The main finding was that patients treated with canagliflozin had better blood sugar control and greater weight loss than those treated with sitagliptin.

There are many different types of drugs used in the treatment of T2D. Canagliflozin (Invokana) is an SGLT-2 inhibitor. It works by preventing sugar from being taken back up into the body after it is filtered out of the blood in the kidney. Instead, the sugar is removed from the body in the urine. Sitagliptin (Januvia) is a DPP-4 inhibitor. It works by making the body produce more insulin (the hormone that controls blood sugar).

Previous studies have shown that patients treated with canagliflozin had greater reductions in HbA1c (blood test measuring blood sugar control after the past 3 months). However, it is not known how canagliflozin compares to sitagliptin for long term blood sugar control and weight loss.

This study included 14,542 patients with T2D who were started on canagliflozin (CANA) and 15,151 patients with T2D who were started on sitagliptin (SITA).

CANA patients were 12-15% more likely to reach target HbA1Cs in comparison to SITA patients. CANA patients were also 47% more likely to lose more than 5% body weight. They were 31% less likely to need another new antidiabetic drug in comparison to SITA patients. Patients who were treated with CANA were 10-15% less likely to fail to maintain their blood sugar control (measured by HbA1c) compared to SITA treated patients.

The authors concluded that patients treated with CANA were more likely to reach target HbA1c, experience weight loss and maintain HbA1c at target range compared to patients treated with SITA.

This study was funded by Janssen Scientific Affairs, LLC., the developers of canagliflozin.