medwireNews: Canagliflozin reduces the risk for major cardiovascular events and kidney failure versus placebo in patients with type 2 diabetes and chronic kidney disease with and without a known history of cardiovascular disease, CREDENCE study data show.
The primary analysis of the CREDENCE data, previously reported by medwireNews showed that overall, canagliflozin 100 mg/day reduced the risk for the composite outcome of end-stage kidney disease, doubling of serum creatinine, or renal or cardiovascular death by 30% relative to placebo.
In the current subanalysis, presented at the 79th ADA Scientific Sessions in San Francisco, California, USA, the researchers focused on primary and secondary prevention subgroups. That is, patients with CV risk factors but no history of CV disease (n=2181) and those with a history of coronary, cerebrovascular or peripheral vascular disease (n=2220).
Christoph Wanner (University Hospital of Würzburg, Germany) reported that the results for the composite outcome in the primary and secondary prevention groups were consistent with those observed for the overall population, with risk reductions of 31% and 30% for canagliflozin and placebo, respectively.
Similar results were observed for a number of other individual and composite cardiovascular and renal outcomes, with no significant differences between the primary and secondary prevention groups.
For example, canagliflozin reduced the risk for hospitalization for heart failure by a significant 39% in both groups. There were also significant 35% and 28% reductions in the risk for dialysis, kidney transplantation, or renal death in the primary and secondary prevention groups, respectively.
Furthermore, there were fewer adverse events and serious adverse events with canagliflozin versus placebo, with no significant difference between the primary and secondary prevention groups.
Commenting on the findings in a statement to the press, co-principal investigator Kenneth Mahaffey (Stanford University, California, USA) said: “We are excited for our patients about the magnitude of the improvement in kidney and heart outcomes. The benefits were consistent in many different subgroups of patients, and this is the first treatment advance for patients with type 2 diabetes and chronic kidney disease in nearly two decades.”
Speaking during the CREDENCE symposium, Bernard Zinman (Mount Sinai Hospital, Toronto, Ontario, Canada) noted that data from the trial resulted in the ADA updating their living guidelines to say: “For patients with type 2 diabetes and diabetic kidney disease, consider use of an SGLT2 inhibitor in patients with an eGFR ≥30 mL/min per 1.73m2 and particularly in those with >300 mg/g albuminuria to reduce risk of CKD progression, cardiovascular events, or both.”
Zinman concluded that although canagliflozin may be considered as a drug for cardiovascular disease or chronic kidney disease, ultimately it “is a diabetes drug with major added value.”
By Laura Cowen
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