CANadian CAnagliflozin REgistry (CanCARE)—A Prospective, Observational Assessment of Canagliflozin (CANA) Treatment in Type 2 Diabetes Mellitus (T2DM)—Twelve-Month Results

医学 卡格列净 前瞻性队列研究 不利影响 内科学 养生 多尿 2型糖尿病 外科 减肥 低血糖 糖尿病 肥胖 内分泌学 胰岛素
作者
Vincent Woo,Alan Bell,Maureen Clement,Fernando Camacho,Natasha Georgijev,Jennifer B. Rose,Wally Rapattoni,Harpreet S. Bajaj
出处
期刊:Diabetes [American Diabetes Association]
卷期号:67 (Supplement_1)
标识
DOI:10.2337/db18-1184-p
摘要

CanCARE is a Canadian multicenter, prospective cohort study that enrolled SGLT2 inhibitor-naïve adult patients with T2DM, with A1c ≥7% on a stable anti-hyperglycemic agent (AHA) regimen at baseline and eGFR ≥ 60 mL/min/1.73m2, who were initiated on CANA as part of their usual treatment. This real-world (RW)study assessed the effectiveness and safety outcomes of the enrolled cohort of 527 subjects (mean age 60.7 years, mean baseline A1c 8.3%) over 12 months. Mean A1c reduction was -1.(1.12), with an observed dose response: -0.96 for CANA 100mg, -1.20 for CANA 300mg. 84.9%, 57.9% and 33% of subjects experienced >0%, ≥3%, ≥5% weight loss, respectively. Overall, 38.8% of subjects achieved A1c <7.0%, while 41% achieved the composite endpoint of A1c reduction ≥ 0.5%, body weight loss ≥ 3%. 17.9% subjects discontinued CANA. Safety data showed 37.4% subjects had ≥ 1 Adverse Event (AE), 3.5% had serious AEs, 14.5% had AEs special Interest: genital mycotic infections (9.5%), polyuria (3.7%), UTI (1.5%), severe hypoglycemia (0.9%) and volume-related AE (0.7%). No reports to date of diabetic ketoacidosis or amputation. CANA shows sustained, clinical meaningful improvement in cardiometabolic (CM) parameters in the RW, confirming findings from Phase 3 trials. Table 1: Baseline Values, Results of CM Parameters at 6 and 12 Months After CANA Initiation.Vital of Lab ValueBaseline6 Months12 MonthsChange 6 Months from Baseline mean (std)Change 12 Months from Baseline mean (std)Hemoglobin A1C (%)8.47.47.3-0.90 (1.16)-1.(1.12)Hemoglobin A1C (mmol/mol)68.857.756.2-33.34 (12.68)-35.(12.23)Weight (kg)90.188.589.4-2.87 (4.62)-3.24 (4.81)Body Mass Index (kg/m2)32.131.631.8-1.02 (1.61)-1.15 (1.68)Waist Circumference (cm)107.4104.7105.9-3.11 (9.39)-2.91 (11.12)Diastolic Blood Pressure (mmHg)78.375.375.3-2.90 (8.78)-3.50 (8.68)Systolic Blood Pressure (mmHg)130.8126.1126.3-4.52 (13.64)-4.65 (13.04)Glomerular Filtration Rate Corrected (mL/min/1.73ml2)85.881.381.4-3.96 (10.72)-5.55 (11.50)Potassium (mmol/L)4.44.54.50.04 (0.37)0.(0.40)HDLCholesterol (mmol/L)1.21.21.20.02 (0.43)0.(0.31)LDLCholesterol (mmol/L)1.91.92.00.01 (0.57)0.01 (0.65)Cholesterol (mmol/L)3.94.03.90.09 (0.76)0.(0.84)Triglycerides (mmol/L)1.91.81.7-0.(0.96)-0.24 (1.17)Triglycerides (mg/dL)172.5162.0151.8-7.53 (85.28)-21.27 (103.27)Albumin/Creatinine (mg/mmol)4.73.54.1-0.28 (5.66)-0.70 (7.96)Albumin/Creatinine (mg/g)41.631.336.3-2.47 (50.11)-6.16 (70.48) Disclosure V.C. Woo: Advisory Panel; Self; Janssen Pharmaceuticals, Inc., AstraZeneca, Novo Nordisk Inc., Sanofi, Boehringer Ingelheim Pharmaceuticals, Inc., Merck & Co., Inc. A.D. Bell: Advisory Panel; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Bayer AG, Eli Lilly and Company, Novo Nordisk Inc.. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Servier. M.A. Clement: Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc., AstraZeneca, Novo Nordisk Inc., Sanofi-Aventis, Eli Lilly and Company. F. Camacho: Consultant; Self; Janssen Inc. N. Georgijev: Employee; Self; Janssen Scientific Affairs, LLC. J.B. Rose: Employee; Self; Janssen Pharmaceuticals, Inc. W. Rapattoni: Employee; Self; Janssen Inc, Toronto Canada. H.S. Bajaj: Speaker's Bureau; Self; Abbott. Advisory Panel; Self; Amgen Inc.. Speaker's Bureau; Self; Amgen Inc.. Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca. Research Support; Self; AstraZeneca. Speaker's Bureau; Self; AstraZeneca, Bayer AG. Advisory Panel; Self; Boehringer Ingelheim GmbH. Research Support; Self; Boehringer Ingelheim GmbH. Speaker's Bureau; Self; Boehringer Ingelheim GmbH. Advisory Panel; Self; Eli Lilly and Company. Research Support; Self; Eli Lilly and Company. Speaker's Bureau; Self; Eli Lilly and Company. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Research Support; Self; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc., Medtronic. Advisory Panel; Self; Merck & Co., Inc.. Research Support; Self; Merck & Co., Inc.. Speaker's Bureau; Self; Merck & Co., Inc., Mylan. Advisory Panel; Self; Novo Nordisk Inc.. Research Support; Self; Novo Nordisk Inc.. Speaker's Bureau; Self; Novo Nordisk Inc.. Advisory Panel; Self; Sanofi. Research Support; Self; Sanofi. Speaker's Bureau; Self; Sanofi. Advisory Panel; Self; Valeant Pharmaceuticals International, Inc.. Research Support; Self; Valeant Pharmaceuticals International, Inc.. Speaker's Bureau; Self; Valeant Pharmaceuticals International, Inc..

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