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Adverse drug events observed in patients with type 2 diabetes mellitus treated with 100   mg versus 300   mg canagliflozin: a systematic review and meta-analysis of published randomized controlled trials

View Article: PubMed Central - PubMed

ABSTRACT

Background: Nowadays, canagliflozin monotherapy, or in combination with other oral hypoglycemic agents (OHAs), is often administered in patients who are treated for type 2 diabetes mellitus (T2DM). Therefore, we aimed to systematically compare the adverse drugs events (AEs) which were associated with 100 mg versus 300 mg canagliflozin respectively, using a large number of randomized patients with T2DM which were obtained from published trials.

Methods: Randomized controlled trials (RCTs) comparing 100 mg versus 300 mg canagliflozin in patients who were treated for T2DM were searched from electronic databases. AEs reported during a follow up period ranging from 12 to 104 weeks were considered as the clinical endpoints in this analysis. We calculated odds ratios (OR) with 95% confidence intervals (CIs) and the analyses were carried out by RevMan 5 · 3 software.

Results: Ten trials involving a total number of 5394 patients (2604 patients who were treated with 100 mg canagliflozin and 2790 patients who were treated with 300 mg canagliflozin) were included. The current results showed that serious AEs were not significantly higher in patients who were treated by 300 mg canagliflozin, with OR: 1.01, 95% CI: 0.79–1.29; P = 0.93. Also, a similar rate of death was observed in patients who were treated by either 100 or 300 mg canagliflozin with OR: 1.13, 95% CI: 0.43–2.94; P = 0.80. Urinary tract infections, postural dizziness and hypoglycemia were also similarly manifested, with OR: 0.93, 95% CI: 0.70–1.23; P = 0.61, OR: 1.51, 95% CI: 0.42–5.37; P = 0.53 and OR: 0.96, 95% CI: 0.81–1.13; P = 0.60 respectively. However, drug discontinuation due to AEs significantly favored 100 mg canagliflozin only during this unequal follow-up period with OR: 1.35, 95% CI: 1.06–1.72; P = 0.01, but it was not significantly different when trials with similar follow-up periods were analyzed.

Conclusion: 300 mg canagliflozin was not associated with significantly higher adverse events compared to 100 mg canagliflozin in those patients who were treated for T2DM. However, because this result was partly affected by other anti-diabetic medications which were included in the treatment regimen, further studies based on patients who were treated strictly on canagliflozin monotherapy should be recommended to completely solve this issue.

No MeSH data available.


Related in: MedlinePlus

Adverse drug events associated with 100 and 300 mg canagliflozin (mean follow-up of 52 weeks)
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Fig4: Adverse drug events associated with 100 and 300 mg canagliflozin (mean follow-up of 52 weeks)

Mentions: Four trials had a follow-up period of 52 weeks. When these four trials were analyzed separately from the main result, no significant difference was observed in serious adverse drug events and UTIs with OR: 0.90, 95% CI: 0.53–1.53; P = 0.69 and OR: 0.82, 95% CI: 0.53–1.27; P = 0.38 respectively. Drug discontinuation due to adverse events was also not significantly different with OR:0.92, 95% CI: 0.58–1.47; P = 0.73 as shown in Fig. 4. Any adverse event was also similarly manifested with OR: 1.01, 95% CI: 0.59–1.75; P = 0.96 (Fig. 5).Fig. 4


Adverse drug events observed in patients with type 2 diabetes mellitus treated with 100   mg versus 300   mg canagliflozin: a systematic review and meta-analysis of published randomized controlled trials
Adverse drug events associated with 100 and 300 mg canagliflozin (mean follow-up of 52 weeks)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5392384&req=5

Fig4: Adverse drug events associated with 100 and 300 mg canagliflozin (mean follow-up of 52 weeks)
Mentions: Four trials had a follow-up period of 52 weeks. When these four trials were analyzed separately from the main result, no significant difference was observed in serious adverse drug events and UTIs with OR: 0.90, 95% CI: 0.53–1.53; P = 0.69 and OR: 0.82, 95% CI: 0.53–1.27; P = 0.38 respectively. Drug discontinuation due to adverse events was also not significantly different with OR:0.92, 95% CI: 0.58–1.47; P = 0.73 as shown in Fig. 4. Any adverse event was also similarly manifested with OR: 1.01, 95% CI: 0.59–1.75; P = 0.96 (Fig. 5).Fig. 4

View Article: PubMed Central - PubMed

ABSTRACT

Background: Nowadays, canagliflozin monotherapy, or in combination with other oral hypoglycemic agents (OHAs), is often administered in patients who are treated for type 2 diabetes mellitus (T2DM). Therefore, we aimed to systematically compare the adverse drugs events (AEs) which were associated with 100 mg versus 300 mg canagliflozin respectively, using a large number of randomized patients with T2DM which were obtained from published trials.

Methods: Randomized controlled trials (RCTs) comparing 100 mg versus 300 mg canagliflozin in patients who were treated for T2DM were searched from electronic databases. AEs reported during a follow up period ranging from 12 to 104 weeks were considered as the clinical endpoints in this analysis. We calculated odds ratios (OR) with 95% confidence intervals (CIs) and the analyses were carried out by RevMan 5 · 3 software.

Results: Ten trials involving a total number of 5394 patients (2604 patients who were treated with 100 mg canagliflozin and 2790 patients who were treated with 300 mg canagliflozin) were included. The current results showed that serious AEs were not significantly higher in patients who were treated by 300 mg canagliflozin, with OR: 1.01, 95% CI: 0.79–1.29; P = 0.93. Also, a similar rate of death was observed in patients who were treated by either 100 or 300 mg canagliflozin with OR: 1.13, 95% CI: 0.43–2.94; P = 0.80. Urinary tract infections, postural dizziness and hypoglycemia were also similarly manifested, with OR: 0.93, 95% CI: 0.70–1.23; P = 0.61, OR: 1.51, 95% CI: 0.42–5.37; P = 0.53 and OR: 0.96, 95% CI: 0.81–1.13; P = 0.60 respectively. However, drug discontinuation due to AEs significantly favored 100 mg canagliflozin only during this unequal follow-up period with OR: 1.35, 95% CI: 1.06–1.72; P = 0.01, but it was not significantly different when trials with similar follow-up periods were analyzed.

Conclusion: 300 mg canagliflozin was not associated with significantly higher adverse events compared to 100 mg canagliflozin in those patients who were treated for T2DM. However, because this result was partly affected by other anti-diabetic medications which were included in the treatment regimen, further studies based on patients who were treated strictly on canagliflozin monotherapy should be recommended to completely solve this issue.

No MeSH data available.


Related in: MedlinePlus