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March 16, 2023
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Canagliflozin remains effective for men, women of varying ages with type 2 diabetes, CKD

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Key takeaways:

  • Impacts of canagliflozin on kidney and cardiovascular events were consistent across age groups and sex.
  • Drug effect was more pronounced in younger patients with higher risk to kidney events.

Among patients with type 2 diabetes and albuminuric chronic kidney disease, canagliflozin reduced kidney and cardiovascular events independent of age or sex, according to data published in the American Journal of Kidney Diseases.

Tae Won Yi, MD, from the George Institute for Global Health at the University of New South Wales in Australia, and colleagues examined 4,401 patients with type 2 diabetes and albuminuric CKD for a secondary analysis of the randomized controlled Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) Trial. Median follow-up was 2.62 years.

diabetes
The effect of canagliflozin did not vary between age groups or sexes. Image: Adobe Stock

Patients were randomly assigned to receive either 100 mg of canagliflozin daily or placebo. Researchers considered the composite of kidney failure, doubling serum creatinine or death due to kidney or cardiovascular disease as the primary outcome.

Using Cox regression models, researchers measured the outcome by age at baseline and sex in the intention-to-treat population. Specifically, researchers aimed to determine if canagliflozin was as effective and safe for men and women, and patients younger than 60 years, aged between 60 and 69 years, and aged at least 70 years.

Analyses revealed being older and a woman independently correlated with a reduced risk of the composite of adverse kidney outcomes. The effect of canagliflozin did not vary between age groups or sexes. Moreover, researchers did not identify differences in safety outcomes by age group or sex.

“In conclusion, the CREDENCE data suggests that canagliflozin consistently improves kidney and cardiovascular outcomes with little variation in risk of adverse events in patients with type 2 diabetes and albuminuric chronic kidney disease across a broad range of ages and in both males and females. The absolute benefit of canagliflozin was greater in younger participants who were at higher risk of adverse kidney outcomes,” Yi and colleagues wrote. “These findings should help to clarify decision-making for those with diabetes and chronic kidney disease.”