Abstract: FR-PO1058

Canagliflozin and Renal Outcomes in Type 2 Diabetes: Data from the CANVAS Program

Session Information

Category: Diabetes

  • 502 Diabetes Mellitus and Obesity: Clinical

Authors

  • Perkovic, Vlado, The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia
  • Rosenthal, Norm, Janssen Research & Development, LLC, Raritan, New Jersey, United States
  • Desai, Mehul, Janssen Research & Development, LLC, Raritan, New Jersey, United States
  • Matthews, David R., University of Oxford, Oxford, United Kingdom
  • Neal, Bruce, The George Institute for Global Health, UNSW Sydney, Sydney, New South Wales, Australia
  • de Zeeuw, Dick, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
  • Mahaffey, Kenneth W., Stanford Center for Clinical Research (SCCR), Stanford University, Department of Medicine, Stanford, California, United States
  • Fulcher, Greg, The Royal North Shore Hospital and University of Sydney, Sydney, New South Wales, Australia
  • Erondu, Ngozi, Janssen Research & Development, LLC, Raritan, New Jersey, United States
  • Shaw, Wayne, Janssen Research & Development, LLC, Raritan, New Jersey, United States
  • Barrett, Terrance D., Janssen Research & Development, LLC, Raritan, New Jersey, United States
  • Weidner-Wells, Michele, Janssen Research & Development, LLC, Raritan, New Jersey, United States
  • Deng, Hsiaowei, Janssen Research & Development, LLC, Raritan, New Jersey, United States

Group or Team Name

  • CANVAS Program collaborative group
Background

Canagliflozin (CANA) is an SGLT2 inhibitor that may have beneficial effects on the kidney in people with diabetes. The effects of CANA on prespecified renal outcomes in people with type 2 diabetes (T2D) and an elevated risk of cardiovascular (CV) disease were assessed in the CANagliflozin cardioVascular Assessment Study (CANVAS) Program.

Methods

The CANVAS Program consists of 2 double-blind, randomized trials conducted in 10,142 people with T2D and elevated CV risk (defined by the presence of documented CV disease or ≥2 risk factors), who received CANA (pooled analysis of 100 and 300 mg doses) or matching placebo (PBO). The prespecified exploratory renal outcomes were changes in urinary albumin:creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), and composite clinical outcomes.

Results

At baseline, median UACR was 12.3 mg/g and mean eGFR was 76.5 mL/min/1.73 m2. Urinary albumin excretion was 18% lower in participants treated with CANA versus PBO overall (95% CI 16%-20%), and 34% (95% CI 29%-38%) and 36% (95% CI 28%-43%) lower in participants with micro- and macroalbuminuria, respectively. Annual rate of eGFR decline was also reduced (difference 1.31 mL/min/1.73 m2/year, 95% CI 1.15-1.48). The composite outcome of end-stage kidney disease, doubled serum creatinine, or renal death occurred less frequently in the CANA group (hazard ratio 0.53, 95% CI 0.33-0.84). Rates of renal adverse events were similar with CANA and PBO.

Conclusion

CANA reduced urinary albumin excretion, slowed eGFR decline, and reduced the risk of substantial loss of kidney function.

Funding

  • Commercial Support