Impact of Canagliflozin on Kidney and Cardiovascular Outcomes by Type 2 Diabetes Duration: A Pooled Analysis of the CANVAS Program and CREDENCE Trials

被引：9

作者：

Tobe, Sheldon W. ^{[1
,2
]}

Mavrakanas, Thomas A. ^{[3
,4
]}

Bajaj, Harpreet S. ^{[5
]}

Levin, Adeera ^{[6
]}

Tangri, Navdeep ^{[7
,8
]}

Slee, April ^{[9
]}

Neuen, Brendon L. ^{[10
,11
]}

Perkovic, Vlado ^{[10
,11
,12
]}

Mahaffey, Kenneth W. ^{[13
]}

Rapattoni, Wally ^{[14
]}

Ang, Fernando G. ^{[14
]}

机构：

[1] Sunnybrook Res Inst, Toronto, ON, Canada

[2] Northern Ontario Sch Med, Sudbury, ON, Canada

[3] McGill Univ Hlth Ctr, Dept Med, Div Nephrol, Montreal, PQ, Canada

[4] Res Inst, Montreal, PQ, Canada

[5] LMC Healthcare, Brampton, ON, Canada

[6] Univ British Columbia, Div Nephrol, Vancouver, BC, Canada

[7] Seven Oaks Gen Hosp, Chron Dis Innovat Ctr, Winnipeg, MB, Canada

[8] Univ Manitoba, Dept Internal Med, Winnipeg, MB, Canada

[9] New Arch Consulting, Seattle, WA USA

[10] Univ New South Wales Sydney, George Inst Global Hlth, Sydney, NSW, Australia

[11] Royal North Shore Hosp, Sydney, NSW, Australia

[12] Univ New South Wales Sydney, Fac Med, Sydney, NSW, Australia

[13] Stanford Univ, Sch Med, Dept Med, Stanford Ctr Clin Res, Stanford, CA USA

[14] Janssen Inc, Toronto, ON, Canada

来源：

DIABETES CARE | 2024年 / 47卷 / 03期

基金：

加拿大健康研究院;

关键词：

RATIONALE; DESIGN;

D O I：

10.2337/dc23-1450

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVE The study was undertaken because it was unknown whether the duration of type 2 diabetes modifies the effects of sodium-glucose cotransporter 2 inhibitor canagliflozin on cardiovascular (CV) and kidney outcomes. RESEARCH DESIGN AND METHODS This post hoc analysis of the Canagliflozin Cardiovascular Assessment Study (CANVAS) Program (N = 10,142) and Evaluation of the Effects of Canagliflozin on Renal and Cardiovascular Outcomes in Participants With Diabetic Nephropathy (CREDENCE) trial (N = 4,401) evaluated hazard ratios and 95% CIs using Cox proportional hazards for the effects of canagliflozin on CV and kidney outcomes, including progression and regression of albuminuria over 5-year intervals of disease duration. RESULTS Canagliflozin had ranges of benefit across intervals of diabetes duration, with no heterogeneity for major adverse CV events, CV death or heart failure hospitalization, and kidney failure requiring therapy or doubling serum creatinine. Furthermore, canagliflozin reduced albuminuria progression and increased albuminuria regression with no interaction across all diabetes duration subgroups. CONCLUSIONS Our findings suggest that earlier treatment with canagliflozin confers consistent cardiorenal benefits to individuals with type 2 diabetes.

引用

页码：501 / 507

页数：7

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