Baseline Kidney Function Does Not Affect CV or Renal Outcomes for Canagliflozin

The cardiovascular (CV) and renal outcomes of glucose-lowering therapy with canagliflozin were not affected by baseline levels of kidney function in patients with type 2 diabetes, a new analysis of the CANVAS trial reports.             

Researchers randomized 10,142 patients with type 2 diabetes and estimated glomerular filtration rate (eGFR) >30 mL/min/1.73 m2 to receive either canagliflozin or placebo. The primary outcome of interest was composite CV death, nonfatal myocardial infarction, or nonfatal stroke, as well as other CV and renal outcomes. The current analysis focused on outcomes in patients with chronic kidney disease (eGFR <60 and ≥60 mL/min/1.73 m2) and according to baseline kidney function (eGFR <45, 45 to <60, 60 to <90, and ≥90 mL/min/1.73 m2).  

According to the study results, canagliflozin did not affect the primary study outcomes in patients with chronic kidney disease (HR=0.70; 95% CI, 0.55 to 0.90) and also in patients with preserved kidney function (HR=0.92; 95% CI, 0.79 to 1.07). The study also reported similar relative effects on CV and renal outcomes across all eGFR subgroups. 

“The effects of canagliflozin on cardiovascular and renal outcomes were not modified by baseline level of kidney function in people with type 2 diabetes and a history or high risk of cardiovascular disease down to eGFR levels of 30 mL/min/1.73 m2,” the authors wrote in their conclusion. “Reassessing current limitations on the use of canagliflozin in chronic kidney disease may allow additional individuals to benefit from this therapy.” 

Source: Circulation