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

Sheldon W Tobe1,2, Thomas A Mavrakanas3, Harpreet S Bajaj4

  • 1Sunnybrook Research Institute, Toronto, Ontario, Canada.

Diabetes Care
|January 22, 2024
PubMed
Abstract

Insights

Early use of canagliflozin provides consistent cardiovascular and kidney benefits for type 2 diabetes patients, regardless of disease duration. This sodium-glucose cotransporter 2 inhibitor demonstrates broad efficacy in managing cardiorenal outcomes.

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Type 2 diabetes (T2D) management requires addressing cardiovascular (CV) and kidney disease risks.
  • The impact of T2D duration on the efficacy of sodium-glucose cotransporter 2 inhibitors (SGLT2i) like canagliflozin remains unclear.

Purpose of the Study:

  • To investigate if the duration of T2D influences the cardiorenal benefits of canagliflozin.
  • To analyze the effects of canagliflozin on CV and kidney outcomes across different T2D durations.

Main Methods:

  • Post hoc analysis of two large trials: CANVAS Program (N=10,142) and CREDENCE (N=4,401).
  • Utilized Cox proportional hazards models to assess hazard ratios and 95% CIs.
  • Examined outcomes including major adverse CV events, CV death, heart failure hospitalization, kidney failure, doubling of serum creatinine, and albuminuria progression/regression over 5-year intervals.

Main Results:

  • Canagliflozin demonstrated consistent benefits across all evaluated diabetes duration intervals.
  • No significant heterogeneity was observed for major adverse CV events, CV death/heart failure hospitalization, or kidney failure/doubling of serum creatinine.
  • Canagliflozin effectively reduced albuminuria progression and increased albuminuria regression, with no interaction across diabetes duration subgroups.

Conclusions:

  • The cardiorenal benefits of canagliflozin are consistent irrespective of type 2 diabetes duration.
  • Earlier initiation of canagliflozin treatment is associated with sustained cardiorenal protection in individuals with type 2 diabetes.

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