Key result
Canagliflozin 100 mg marginally reduces SBP versus placebo in T2D without improving HbA1c or BMI.
Why the study?
Canagliflozin is an authorized therapy for T2DM, but its effects on cardiovascular disease risk factors including HbA1c, BMI, and SBP needed review and evaluation.
Does canagliflozin reduce HbA1c, BMI, and SBP in patients with type 2 diabetes mellitus and cardiovascular disease?
Meta-Analysis
Does canagliflozin reduce HbA1c, BMI, and SBP in patients with type 2 diabetes mellitus and cardiovascular disease?
Effect estimate: SMD -0.03 (95% CI -0.07, 0.00)
p-value: p=0.06
In patients with T2DM and CVD, canagliflozin 100 mg reduces systolic blood pressure but does not significantly decrease BMI or HbA1c compared to placebo.
Minimal SBP reduction without HbA1c or BMI effects at canagliflozin 100 mg; challenges standard SGLT2i benefits in T2DM with CVD.
BACKGROUND: Canagliflozin or sodium-glucose co-transporter 2 inhibitor (SGLT2i) is considered as an authorized therapeutic drug for treatment of patients with type 2 diabetes mellitus (T2DM). This study reviews and evaluates the effects of Canagliflozin on Hemoglobin (HbA1c), Body Mass Index (BMI) and Systolic Blood Pressure (SBP). METHODS: This fixed-effects systematic review and meta-analysis are based on 38 comprehensive literature survey and statistical analysis of selected references that explore the effect of canagliflozin in patients having cardiovascular disease (CVD) and T2DM. The data were analyzed and interpreted at 95% Confidence Interval with reference to placebo-controlled randomized controlled trails (RCTs). RESULTS: The effects of canagliflozin at 100 and 300 doses slightly reduced Hemoglobin A1c (HbA1c) and Body Mass Index (BMI) without significant differences with placebo [HbA1c at 100 mg, effect size: -0.005, Confidence Interval of 95% = -0.04 to 0.03, (P = 0.79), at 300 mg, effect size: -0.03 (-0.11 to 0.05), (P = 0.43), BMI at 100 mg, effect size: -0.01 (-0.04 to 0.02), (P = 0.57) and at 300 mg, effect size was 0.02 (-0.05 to 0.10), (P = 0.55)]. At 100 mg dose, canagliflozin lowers systolic blood pressure compared to that of placebo (effect size: -0.03 (-0.07, 0.00), (P = 0.06)]. These data up to date reveal that the most significant effective role of canagliflozin in patients having T2DM is to reduce the systolic blood pressure. CONCLUSION: This systematic review and meta-analysis highlight that although canagliflozin does not project significant decrease on BMI and HbA1c, yet in 100 mg doses significantly reduces SBP in patients with T2DM. Further future research in the coming years may provide more data and information on the protective role of canagliflozin in patients with T2DM.
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Aftabi et al. (2025) conducted a meta-analysis in Type 2 diabetes mellitus. Canagliflozin vs. Placebo was evaluated on Systolic blood pressure (SBP) at 100 mg (SMD -0.03, 95% CI -0.07, 0.00, p=0.06). Canagliflozin at 100 mg marginally reduced systolic blood pressure compared to placebo (SMD -0.03) in patients with type 2 diabetes, while showing no significant effect on HbA1c or BMI.
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