Key result
Canagliflozin reduced the risk of major cardiovascular events by 20% (HR 0.80) compared to placebo in patients with type 2 diabetes mellitus and chronic kidney disease, with consistent benefits regardless of prior cardiovascular disease history.
Why the study?
Effects of canagliflozin on specific cardiovascular outcomes and in patients without previous cardiovascular disease (primary prevention) were uncertain.
Does canagliflozin reduce major cardiovascular events in patients with type 2 diabetes mellitus and chronic kidney disease in both primary and secondary prevention groups?
RCT (n=4,401)
Double-blind
1:1
Yes
Does canagliflozin reduce major cardiovascular events in patients with type 2 diabetes mellitus and chronic kidney disease in both primary and secondary prevention groups?
Hazard Ratio: 0.8 (95% CI 0.67–0.95)
Absolute Event Rate: 9.9% vs 12.2%
Number Needed to Treat: 40
p-value: p=0.01
Canagliflozin reduces major cardiovascular events in patients with type 2 diabetes and chronic kidney disease, with consistent benefits observed regardless of prior cardiovascular disease status.
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Supports canagliflozin for MACE reduction even without prior CVD in T2DM and CKD; challenges meta-analyses limiting SGLT2i benefit to secondary prevention.
Mahaffey et al. (2019) conducted an RCT in Type 2 diabetes mellitus and chronic kidney disease (n=4,401). Canagliflozin vs. Placebo was evaluated on Major cardiovascular events (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) (HR 0.80, 95% CI 0.67-0.95, p=0.01). Canagliflozin reduced the risk of major cardiovascular events by 20% (HR 0.80) compared to placebo in patients with type 2 diabetes mellitus and chronic kidney disease, with consistent benefits regardless of prior cardiovascular disease history.
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