Impact of Canagliflozin on Renoprotection in T2DM

SGLT2 Inhibitors and Renoprotection: What’s the Evidence? Authors of the CANVAS study sought to determine the impact of canagliflozin on a range of renal outcomes in T2DM patients who were at a high risk of CV events. 

CANVAS: Long-term Impact of Canagliflozin on Renal Outcomes.³ CANVAS consisted of 2 double-blind, masked randomized trials that looked at canagliflozin vs placebo in 10 142 T2DM patients with high CV risk at 667 centers in 30 countries. Patients were randomized to receive 300 mg canagliflozin, 100 mg canagliflozin, or placebo daily. Mean follow-up was 3.6 years. 

Benefits Seen in Broad Range of Renal Outcomes. Kidney function stabilized for canagliflozin vs placebo. There was a 47% lower risk of sustained doubling of serum creatinine, end-stage kidney disease, and death from renal causes; an 18% reduction in albuminuria; a 20% lower risk of new-onset albuminuria; and a slower annual eGFR decline. Serious renal-related adverse events were similar for canagliflozin vs placebo. 

Clinical Implications. CANVAS study supports using SGLT2 inhibitors for renoprotection in T2DM patients. Results of the study are not likely to lead to new indications for kidney disease prevention with SGLT2 inhibitors. CREDENCE is the first dedicated trial of SGLT2 inhibitors and renal outcomes with final data analysis pending.