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Abstract: PO0748

Effects of Canagliflozin (CANA) on Kidney Outcomes: Pooled Analyses from the CANVAS Program and CREDENCE

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Levin, Adeera, Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada
  • Cherney, David, University of Toronto, Toronto, Ontario, Canada
  • Wheeler, David C., The George Institute for Global Health, UNSW Sydney, Australia
  • Gogate, Jagadish, Janssen Scientific Affairs, LLC, Titusville, New Jersey, United States
  • Haynes, Marsha, Janssen Canada, Inc., Toronto, Ontario, Canada
  • Perkovic, Vlado, The George Institute for Global Health, UNSW Sydney, New South Wales, Australia
Background

CANA reduced the risk of sustained loss of kidney function in patients with type 2 diabetes mellitus (T2DM) and high cardiovascular (CV) risk or nephropathy. We analyzed the effects of CANA on time to first occurrence of doubling of serum creatinine (SCr) and end-stage kidney disease (ESKD) events using pooled data from the CANVAS Program and CREDENCE.

Methods

This post hoc analysis included integrated data from the CANVAS Program and CREDENCE trials. The effects of CANA compared with placebo (PBO) on doubling of SCr and ESKD were examined in subgroups by baseline estimated glomerular filtration rate (eGFR; <45, 45-60, and >60 mL/min/1.73 m2). Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using a Cox proportional hazards model, stratified by trial.

Results

A total of 14,543 participants from the CANVAS Program (N = 10,142) and CREDENCE (N = 4,401) were included. Among participants with baseline eGFR measurements, 1919 (13.2%) had eGFR <45 mL/min/1.73 m2, 2972 (20.4%) had eGFR 45-60 mL/min/1.73 m2, and 9649 (66.3%) had eGFR >60 mL/min/1.73 m2. CANA delayed the time to first doubling of SCr event and first ESKD event relative to PBO. Compared with PBO, CANA reduced the risk of doubling SCr (HR, 0.58; 95% CI, 0.47–0.71) consistently across eGFR subgroups (interaction P = 0.78; Figure). Reduced risk of ESKD was also seen with CANA versus PBO (HR, 0.69; 95% CI, 0.55–0.87), irrespective of baseline eGFR (interaction P = 0.86).

Conclusion

In patients with T2DM and high CV risk or nephropathy, CANA reduced the risk of doubling of SCr and ESKD, with consistent benefits observed across baseline chronic kidney disease stage, including those with preserved eGFR >60 mL/min/1.73 m2.