Canagliflozin versus glimepiride treatment in patients with type 2 diabetes inadequately controlled with metformin (CANTATA-SU trial)

Abstract

Evaluation of: Cefalu WT, Leiter LA, Yoon KH et al. Efficacy and safety of canagliflozin versus glimepiride in patients with Type 2 diabetes inadequately controlled with metformin (CANTATA-SU): 52-week results from a randomized, double-blind, Phase III non-inferiority trial. Lancet 382, 941-950 (2013). The CANTATA-SU study compared two doses of the sodium glucose cotransporter 2 inhibitor canagliflozin (CANA 100 and 300 mg) with the sulfonylurea, glimepiride (6-8 mg) in Type 2 diabetes mellitus patients inadequately controlled on metformin, over 52 weeks. Glimepiride reduced the mean baseline HbA1C from 7.8-6.99%. CANA 100 mg reduced the baseline HbA1C from 7.8-6.98% and CANA 300 mg reduced HbA1C from 7.8-6.87%. Fasting plasma glucose was lowered to a greater extent following CANA 100 mg (1.3 mmol/l) and CANA 300 mg (1.52 mmol/l) as compared to glimepiride (1.02 mmol/l). CANA 100 and 300 mg reduced body weight by 3.7 and 4.0 kg, respectively compared to a 0.7 kg increase with glimepiride. Blood pressure was modestly reduced by both CANA treatments. Both high-density lipoprotein and low-density lipoprotein cholesterol were increased by both doses of CANA compared to glimepiride. Documented hypoglycemia was lower with CANA, but polyuria, pollakiuria, genital mycotic and urinary tract infections were significantly greater in both doses of CANA compared to glimepiride.