Therapeutic effect of canagliflozin on type 2 diabetes mellitus: a systematic review and meta-analysis

Background and Objective: In order to assess the efficacy and safety of canagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, on treatment of type 2 diabetes mellitus (T2DM), we perform this systematic review and meta-analysis. Methods: Randomized controlled trials were identified by searching databases from the period 1960 to 2015, as well as from the reference sections of retrieved articles. Results from individual studies were synthetically combined using Cochrane Collaboration's Review Manager 5.2 software. Results: A total of 7 randomized controlled trials were included in our meta-analysis, involving 4,606 participants. Five trials compared canagliflozin with placebo, one trial compared canagliflozin with sitagliptin, and the other one compared canagliflozin with glimepiride. Five included trials were categorized as low risk and two were moderate. A significant number of subjects achieved HbA1c < 7.0% in canagliflozin groups compared with placebo group. Apart from the genitourinary tract infections, canagliflozin was well tolerated. There was a trend to increase both high and low density lipoprotein cholesterols, but decrease triglycerides in canagliflozin groups compared with control groups. Conclusions: Canagliflozin seems to significantly improve short-term outcomes in participants with T2DM but long-term follow-up data are required.