Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes: CANVAS Program Collaborative Group

June, 2017

June 12, 2017. This study reports on the cardiovascular, renal, and safety outcomes of canagliflozin treatment in patients with type 2 diabetes (T2D) and high cardiovascular (CV) risk. Data were analyzed from 2 trials (N=10,142) in which patients were assigned to receive canagliflozin or placebo and followed for a mean of 188.2 weeks. Mean participant age was 63.3 years, and 65.6% had a history of CV disease. The mean duration of diabetes was 13.5 years. The primary outcome was a composite of death from CV causes, nonfatal myocardial infarction, or nonfatal stroke. The rate of primary outcome events was lower with canagliflozin vs placebo (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.75 to 0.97; P<0.001 for noninferiority; P=0.02 for superiority). There was also a possible benefit of canagliflozin for albuminuria progression (HR, 0.73; 95% CI, 0.67 to 0.79) and a composite outcome of a sustained 40% reduction in estimated glomerular filtration rate, the need for renal-replacement therapy, or death from renal causes (HR, 0.60; 95% CI, 0.47 to 0.77). Adverse reactions were consistent with prior data, with the exception of an increased risk of amputation with canagliflozin (HR, 1.97; 95% CI, 1.41 to 2.75), primarily at the toe or metatarsal.