medwireNews: Treatment with canagliflozin is associated with a reduction in the risk for both first and total heart failure (HF) events in people with type 2 diabetes and chronic kidney disease (CKD), suggests a post-hoc analysis of the CREDENCE trial.
As reported at the virtual ADA 80th Scientific Sessions, 4% of the 4401 CREDENCE participants were hospitalized once for HF over a median of 2.6 years of follow-up, while 1% were hospitalized for HF more than once. Among the 2202 patients treated with the sodium-glucose cotransporter (SGLT)2 inhibitor canagliflozin 100 mg/day, 89 experienced first HF events and 38 had additional events; 141 and 58 of 2199 participants in the placebo group experienced first and additional HF events, respectively.
Presenting author Clare Arnott (University of Sydney, New South Wales, Australia) said that canagliflozin treatment was associated with a significant 39% reduction in the risk for a first HF event and a significant 36% reduction in the risk for total HF events, with a number needed to treat to prevent a first or recurrent HF event of 32.
She noted that the association between canagliflozin use and reduced HF risk was no longer statistically significant for second and third events in a sensitivity analysis categorizing participants by number of HF events, which she attributed to “the low number of participants who had a second or third event throughout the trial.”
Arnott said that the overall burden of hospitalization for HF was particularly high in the CREDENCE trial compared with four other event-driven SGLT2 inhibitor trials (EMPA-REG, DAPA-HF, DECLARE, and CANVAS Program). For instance, the incidence rate for first events in the placebo arm of CREDENCE was 25.5 per 1000 person–years, compared with 8.5–14.5 per 1000 person–years in the other trials.
“This highlights how at-risk those with both type 2 diabetes and chronic kidney disease are of having a heart failure event and the importance of treatment in this group,” she said.
And Arnott concluded that canagliflozin treatment “should be continued” in patients with hospitalization for HF in order to “derive very important benefits for patients.”
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