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Abstract: SA-PO262

Effects of Canagliflozin (CANA) on Cardiovascular (CV), Kidney, and Albuminuria Outcomes by Diabetes Duration: Pooled Analysis From the CANVAS Program and CREDENCE

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Tobe, Sheldon W., Sunnybrook Research Institute, Toronto, Ontario, Canada
  • Bajaj, Harpreet S., LMC Healthcare, Toronto, Ontario, Canada
  • Levin, Adeera, Division of Nephrology, University of British Columbia, Vancouver, British Columbia, Canada
  • Mavrakanas, Thomas, Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada
  • Tangri, Navdeep, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
  • Slee, April E., New Arch Consulting, Seattle, Washington, United States
  • Rapattoni, Wally, Janssen, Inc, Toronto, Ontario, Canada
  • Ang, Fernando G., Janssen, Inc, Toronto, Ontario, Canada
Background

Type 2 diabetes (T2DM) is a progressive disease and increasing duration is associated with heightened risk of morbidity and mortality. CANA reduced CV and kidney events in patients (pts) with T2DM and CV risk or nephropathy. We assessed the effects of CANA on CV and kidney outcomes and albuminuria progression by disease duration.

Methods

This post hoc analysis pooled patient-level data from the CANVAS Program (N=10,142) and the CREDENCE trial (N=4401) to examine the effect of CANA vs placebo on CV events (major adverse cardiovascular events [MACE] and CV death or hospitalization for heart failure), kidney events (doubling of serum creatinine [dSCr] and end-stage kidney disease or dSCr), a composite of CV and kidney events, and albuminuria progression and regression (change in albuminuria class [normo-, micro-, macro-] plus ≥30% urinary albumin to creatinine ratio change) in pts with diabetes duration of <5, ≥5 to ≤10, >10 to ≤15, and >15y. HRs and 95% CIs were estimated using a Cox proportional hazards model, stratified by duration of diabetes.

Results

Overall, there were 1528, 3333, 4148, and 5523 pts with diabetes duration of <5, ≥5 to ≤10, >10 to ≤15, and >15y. CANA reduced the risk of CV, kidney, composite cardiorenal outcomes, with no statistical heterogeneity amongst subgroups by diabetes duration. Similarly, CANA reduced the rate of albuminuria progression and increased rate of albuminuria regression across diabetes duration subgroups (Figure).

Conclusion

CANA reduced the risk of CV, kidney, and composite cardiorenal events consistently, regardless of diabetes duration. Results show within 5 years of developing T2DM, CANA positively impacts on albuminuria, an important consideration in primary care setting.