OBJECTIVES: Canagliflozin (CANA), a sodium glucose co-transporter 2 inhibitor, has been shown to improve glycemic control in clinical trials. This study describes the treatment patterns of antihyperglycemic agents (AHAs) among patients with T2DM receiving CANA in a real-world setting.     METHODS: This retrospective cohort study used data from a large US health plan for commercial and Medicare Advantage enrollees age ≥18 years with T2DM that filled CANA between April-October 2013 (first 7 months on the market).  Six-month baseline and follow-up data were evaluated. Concomitant AHA use was defined as having at least 2 prescriptions, with 1 fill during baseline and 1 fill on/after CANA initiation without a ≥60-day therapy gap.  Discontinuation was defined as a ≥60-day therapy gap.     RESULTS: In this sample (n=4017), 43% were female and average age was 56 years; 826 had baseline and follow-up A1C available.  Approximately 30% of patients used CANA concomitantly with 1 other AHA, while 50% used CANA concomitantly with ≥2 other AHAs; the remaining 20% used CANA alone. The most common baseline regimens comprised oral agents only (43%), and 25% contained insulin.  Of patients using CANA in combination with other AHAs, 20% discontinued use of at least 1 AHA during follow-up. CANA index dose was 100mg for 65% of the population and 300mg for the remainder; 30% of patients initially observed on CANA 100mg titrated to 300mg. Among patients with A1C ≥7.0% at baseline, the proportion of patients with A1C <7% and <8% increased from 0% (baseline) to 21% (follow-up) and 30% (baseline) to 61% (follow-up), respectively; those with A1C ≥9.0% decreased from 33% (baseline) to 16% (follow-up).       CONCLUSIONS: CANA was often prescribed as add-on therapy to multiple AHAs with one-fifth of patients discontinuing use of other AHAs after CANA was added to their treatment regimen. In patients with uncontrolled A1Cs, their A1Cs improved following treatment with CANA.