Canagliflozin Reduces Cardiovascular Events in Patients With Type 2 Diabetes Regardless of Cardiovascular Disease History

November 13, 2017. A prespecified data analysis from the Canagliflozin Cardiovascular Assessment Study (CANVAS) found that canagliflozin, a sodium glucose cotransporter 2 (SGLT-2) inhibitor, reduced cardiovascular (CV) events in patients with type 2 diabetes and with and without a history of CV disease (the secondary prevention cohort, n=6,656, and primary prevention cohort, n=3,486, respectively). The primary endpoint was a composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Secondary outcomes included heart failure hospitalization and a composite of renal events. In the total cohort, the risk of CV events was reduced by 14% in the canagliflozin group vs placebo (hazard ratio: 0.86, 95% confidence interval: 0.75-0.97; P=0.02 for superiority) with no statistical evidence of heterogeneity between the cohorts. The CV event rate was higher, however, in the secondary vs primary prevention group (36.9 vs 15.7/1,000 patient-years, P<0.001). Both cohorts exhibited similar outcomes in terms of reductions in renal outcomes and heart failure hospitalizations, as well as increased lower extremity amputations. You can access the abstract here.