European Journal of Clinical Pharmacology

, Volume 70, Issue 10, pp 1149–1158 | Cite as

Efficacy and safety of canagliflozin in subjects with type 2 diabetes: systematic review and meta-analysis

  • Xu-Ping Yang
  • Dan Lai
  • Xiao-Yan Zhong
  • Hong-Ping Shen
  • Yi-Lan HuangEmail author
Review Article



To assess the efficacy and safety of the novel sodium glucose co-transporter 2 (SGLT2) inhibitor—canagliflozin for type 2 diabetes (T2DM).


A search of Medline (1946–January 2014), Embase (1950–January 2014), and The Cochrane Library for randomized controlled trials of canagliflozin compared to placebo or active comparator in T2DM was performed. Clinical Trials website and unpublished U.S. Food and Drug Administration data were also searched.


Ten trials including 6,701 patients were analyzed. Compared with placebo, canagliflozin produced absolute reductions in glycated hemoglobin A1c levels when used as monotherapy (weighted mean difference (WMD) −1.08 %, 95 % confidence interval (CI) [−1.25 to −0.90], p < 0.00001) or add-on treatment (WMD −0.73 %, 95 %CI [−0.84 to −0.61], p < 0.00001). When compared with other active comparators, canagliflozin significantly reduced HbA1c by −0.21 % (WMD, 95 %CI [−0.33 to −0.08], p = 0.001). Canagliflozin led to greater body weight loss (vs. placebo, WMD −2.81 kg, 95 %CI [−3.26 to −2.37]; vs. active comparators, WMD −3.49 kg, 95 %CI [−4.86 to −2.12]). Hypoglycemia with canagliflozin was similar to placebo or sitagliptin, and was lower than glimepiride (risk ratio (RR) 0.15, 95 %CI [0.10 to 0.22]). Genital tract infections were more common with canagliflozin (vs. placebo, RR 3.76, 95 %CI [2.23 to 6.35]; vs. active comparators, RR 4.95, 95 %CI [3.25 to 7.52]). Similar incidences of urinary tract infections were noted with canagliflozin compared with control groups.


Canagliflozin led to improvements in reducing glycated hemoglobin A1c levels and body weight with low risk of hypoglycemia in patients with T2DM. Common adverse effects including genital tract infections and osmotic diuresis-related AEs were identified and reviewed. Risks of cardiovascular events are even less certain, and more data on long-term effects are needed.


Canagliflozin Sodium glucose co-transporter 2 inhibitor Type 2 diabetes Systematic review 


Conflict of interest

The authors have nothing to disclose

Supplementary material

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Xu-Ping Yang
    • 1
  • Dan Lai
    • 2
  • Xiao-Yan Zhong
    • 4
  • Hong-Ping Shen
    • 1
  • Yi-Lan Huang
    • 3
    Email author
  1. 1.Department of PharmacyThe TCM Hospital Affiliated to Luzhou Medical CollegeLuzhouPeople’s Republic of China
  2. 2.Department of ENTThe Affiliated Hospital of Luzhou Medical CollegeLuzhouPeople’s Republic of China
  3. 3.Department of PharmacyThe Affiliated Hospital of Luzhou Medical CollegeLuzhouPeople’s Republic of China
  4. 4.College of PharmacyLuzhou Medical CollegeLuzhouPeople’s Republic of China

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