Therapeutic Effect Of Canagliflozin On Type2Diabetes: A Systematic Review And Meta-analysis

Objective To assess the efficacy and safety of canagliflozin, a sodium glucosecotransporter2(SGLT2) inhibitor, on treatment of type2diabetes mellitus.Methods Randomized controlled trials were identified from Embase, CochraneCentral Register of Controlled Trials, Pubmed, Web of science and Clinical TrialsRegistry Platform (from inception to August2013), as well as from the referencesections of retrieved articles. The risk of bias was evaluated in all included trials. Tworeviewers independently screened trials according to exclusion and inclusion criteria,extracted data, and assessed the methodological quality. Then, the CochraneCollaboration’s Review Manager5.2software was used for data analysis.Results7randomized controlled trials involving4,606participants were included.For the risk of bias assessment, five of the included trials were categorized as low riskand two were moderate. Five trials compared canagliflozin with placebo, one trialcompared canagliflozin with sitagliptin, and the other one compared canagliflozinwith glimepiride. A significant number of subjects achieved HbA1c <7.0%incanaglifozin groups than placebo or sitagliptin groups. Apart from the predominantadverse genitourinary tract infections effects, canagliflozin was well tolerated, notassociated with hypoglycemia. Canagliflozin significantly reduced body weight infavor of both placebo and other antidiabetic drugs. There was a trend to increase highdensity lipoprotein cholesterols as well as low density lipoprotein cholesterols, anddecrease triglycerides in canagliflozin groups than in control groups.Conclusions Canagliflozin seems to significantly improve short-term outcomes inparticipants with type2diabetes mellitus but longer-term follow-up data is required,especially in analysing cardiovascular safety.