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Canagliflozin Seems Effective for Patients With T2DM, Kidney Disease

Reductions seen in risk for kidney failure, cardiovascular disease with canagliflozin versus placebo

kidney illustration

MONDAY, April 15, 2019 (Pharmacist's Briefing) -- Canagliflozin is associated with a reduced risk for renal and cardiovascular events for patients with type 2 diabetes and kidney disease, according to a study published online April 14 in the New England Journal of Medicine to coincide with the International Society of Nephrology World Congress of Nephrology, held from April 12 to 15 in Melbourne, Australia.

In a double-blind, randomized trial, Vlado Perkovic, M.B., B.S., Ph.D., from the George Institute for Global Health at the University of New South Wales Sydney, and colleagues randomly assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive either canagliflozin (100 mg daily) or placebo.

After a planned interim analysis, the trial was stopped early on the recommendation of the data and safety monitoring committee. The researchers found that at that point, 4,401 patients had undergone random assignment with a median follow-up of 2.62 years. The relative risk of the primary outcome (composite of end-stage kidney disease, a doubling of the serum creatinine level, or death from renal or cardiovascular causes) was lower in the canagliflozin group versus the placebo group (event rates, 43.2 and 61.2 per 1,000 patient-years, respectively; hazard ratio, 0.70). The relative risks of the renal-specific composite of end-stage kidney disease, doubling of the creatinine level, or death from renal causes and end-stage kidney disease were also lower in the canagliflozin group (hazard ratios, 0.66 and 0.68, respectively). The risk for cardiovascular death, myocardial infarction, or stroke was also lower in the canagliflozin group (hazard ratio, 0.61).

"Canagliflozin may be an effective treatment option for renal and cardiovascular protection in patients with type 2 diabetes with chronic kidney disease," the authors write.

The study was funded by Janssen, the manufacturer of canagliflozin.

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