Canagliflozin Lowers Cardiovascular Risks in Type 2 Diabetics

Canagliflozin lowered cardiovascular events, and kidney failure, in patients with type 2 diabetes mellitus, according to a new paper in Circulation.

According to ClincalTrials.gov, the purpose of the  Evaluation of the Effects of Canagliflozin on Renal and Cardiovascular Outcomes in Participants with Diabetic Nephropathy (CREDENCE) was to assess the effects of canaglifozin on both renal and cardiovascular outcomes in type 2 diabetics with diabetic nephropathy.

“Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without prior cardiovascular disease (primary prevention),” the researchers wrote in their abstract.

The researchers looked at 4,401 participants with type 2 diabetes plus chronic kidney disease. Participants were randomized (1:1) to either canagliflozin or placebo with standard care. The primary outcome of interest was the time to first occurrence of an event of the composite endpoint of end-stage kidney disease, doubling of serum creatinine, renal, or cardiovascular death. There were multiple secondary endpoints, including, time to first occurrence of an even in the composite of CV death and hospitalized congestive heart failure; time to first occurrence of an endpoint event in the composite of cardiovascular death, nonfatal myocardial infarction, and others. Primary prevention participants (n=2,181; 49.6%) tended to be younger, more often female, and had a shorter duration of diabetes compared with the secondary prevention groups (n=2,220; 50.4%).

The results showed that canagliflozin lowered the risk for major cardiovascular events overall (HR=0.80; 95% CI, 0.67 to 0.95; P=0.01) in both the primary prevention and secondary prevention groups. These effects were consistent across components of the composite endpoint, including cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke. The risk for the composite renal outcome was reduced, along with the risk of the cardiovascular death or hospitalization or heart failure composite outcome.

“Canagliflozin significantly reduced major cardiovascular events, as well as kidney failure, in patients with type 2 diabetes and chronic kidney disease, including in participants who did not have prior cardiovascular disease,” the researchers concluded.

More data..primary prevention of CVD..Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups: Results from the Randomized CREDENCE Trial| ⁦@CircAHA⁩ https://t.co/Cdi5ze0x7u

— TEJAS PATEL MD, FACP, FASN (@GenNextMD) July 12, 2019

https://t.co/B3ckn3BjwA
Canagliflozin significantly reduced major CVD events, as well as kidney failure, in patients with T2D and chronic kidney disease, including in participants who did not have prior CVD. #CREDENCE #kidneyInCVD @AHAScience @nephJC pic.twitter.com/wLXOr0DCzJ

— Kidney in Cardiovascular Disease (@KidneyInCVD) July 14, 2019

Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups: Results from the Randomized CREDENCE Trial | Circulation https://t.co/hgNNHG0NpE … https://t.co/t2uCSw2c5h pic.twitter.com/ktr3hP46tZ

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— Diego Araiza MD (@drdargaray) July 14, 2019