Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Effect of Canagliflozin (CANA) in Patients With Type 2 Diabetes Mellitus (T2DM) Based on Age and Estimated Glomerular Filtration Rate (eGFR)  (#322)

Richard E Gilbert 1 , Matthew R Weir 2 , Paola Fioretto 3 , Gordon Law 4 , Keith Usiskin 4 , Gary Meininger 4
  1. University of Toronto, St Michael's Hospital, Toronto, Ontario, Canada
  2. University of Maryland Medical Centre, Baltimore, MD, USA
  3. Department of Medicine, University of Padova, Padova, Italy
  4. Janssen Reasearch and Development, Raritan, NJ, USA

CANA, an SGLT2 inhibitor, has demonstrated greater A1C lowering in patients with T2DM aged <65 versus ≥65 y.  As older patients may have lower eGFRs, which can impact the efficacy of CANA, A1C-lowering with CANA was assessed by age and eGFR using pooled data from 6 randomized, double-blind, placebo (PBO)-controlled studies (18 or 26 wk) in patients with T2DM (N = 4,158; age, 59.0 y; A1C, 8.1%; eGFR, 82.1 mL/min/1.73 m2).  Compared with patients <65 y (n = 2,944), those ≥65 y (n = 1,214) had lower mean eGFR (71.4 vs 86.5 mL/min/1.73 m2) and similar mean A1C (8.1% vs 8.2%) at baseline.  CANA 100 and 300 mg significantly reduced A1C versus PBO in all patients, with greater lowering in younger versus older patients (<65 y: –0.72% and –0.87%; ≥65 y: –0.61% and –0.74%; P <0.001).  A1C changes with CANA versus PBO were generally similar in younger and older patients within eGFR subgroups of ≥90 and ≥60 to <90 mL/min/1.73 m2 (Figure); in the smaller subgroup of patients with eGFR ≥45 to <60 mL/min/1.73 m2, A1C reduction with CANA versus PBO was smaller in those ≥65 y.  Overall incidence of adverse events was similar across groups (59%, 60%, and 61% for PBO, CANA 100 and 300 mg, respectively) regardless of age and eGFR.  In summary, CANA reduced A1C and was generally well tolerated across age subgroups, with differences in A1C lowering between patients <65 and ≥65 y possibly reflecting baseline eGFR differences.