Renal Outcomes With Canagliflozin in Type 2 Diabetes From the CANVAS Program

June 21, 2018. The Canagliflozin Cardiovascular Assessment Study (CANVAS) Program included 2 multicenter, double-blind, randomized trials assessing the effects of canagliflozin, a sodium-glucose cotransporter-2 inhibitor, vs placebo on major adverse cardiovascular events. Participants (N=10,142) had type 2 diabetes (T2D) and were at high risk for cardiovascular events. In a prespecified exploratory analysis, the long-term effects of canagliflozin on adjudicated and sustained renal outcomes were evaluated. The composite outcome of end-stage kidney disease, death from renal causes, and sustained doubling of serum creatinine occurred less frequently in patients using canagliflozin vs placebo (1.5 vs 2.8 events per 1,000 patient-years; hazard ratio [HR]: 0.53; 95% confidence interval [CI]: 0.33-0.84). These findings were consistent across patient subgroups. Those using canagliflozin also experienced a slower decline in annual estimated glomerular filtration rate (slope difference between groups was 1.2 mL/min per 1.73 m2 per year; 95% CI: 1.0-1.4) and an 18% lower urinary albumin-to-creatinine ratio (95% CI: 16-20) versus placebo. There were no significant between-group differences in serious renal-related adverse events (2.5 with canagliflozin vs 3.3 placebo per 1,000-patient years; HR: 0.76; 95% CI: 0.49-1.19). These findings suggest a possible renoprotective effect of canagliflozin in patients with T2D. You can read the study abstract here.