Canagliflozin may reduce albuminuria, eGFR decline in patients with type 2 diabetes
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Key takeaways:
- Patients on canagliflozin had a 30.8% decrease in log-transformed geometric mean urinary albumin-to-creatinine ratio.
- eGFR slope change was 4.4 mL/min/1.73 m2 per year higher in the canagliflozin group.
Canagliflozin may reduce albuminuria and patient-specific eGFR decline in patients with type 2 diabetes and microalbuminuria, researchers found in a parallel, open-labeled trial.
“Establishing the eGFR slope before intervention and determining the change in a patient’s individual eGFR trajectory during an intervention period could be a sensitive and efficient approach to identify patients at risk of [chronic kidney disease] CKD progression and evaluate a treatment effect on kidney function decline,” Satoshi Miyamoto, MD, PhD, of the Okayama University Hospital Center for Innovative Clinical Medicine in Japan, wrote with colleagues. “To test this hypothesis, we assessed the effect of canagliflozin (a proven kidney protective drug) compared to care as usual (control) on albuminuria and on the individual’s change in eGFR slope in patients with diabetes and microalbuminuria during a relatively short-term follow-up period.”
Researchers focused on the effects of the SGLT2 inhibitor canagliflozin on patients’ eGFR slope before and during treatment as part of the CANPIONE study. Overall, 98 patients who had type 2 diabetes, urinary albumin-to-creatinine ratio (UACR) of 50 mg/g to 300 mg/g and an eGFR of at least 45 mL/min/1.73 m2 were included. Patients were randomly assigned to receive either canagliflozin or standard guideline-recommended treatment, excluding SGLT2 inhibitors. Of the patients in the study, 96 received at least one treatment.
Researchers found a 30.8% decrease in log-transformed geometric mean UACR in the canagliflozin group compared with the control group. In addition, Miyamoto and colleagues found the change in eGFR slope was 4.4 mL/min/1.73 m2 per year higher in the canagliflozin group, particularly for patients with faster eGFR decline.
Results of the study suggest “the within-individual change in eGFR slope may be a novel approach in identifying participants with steeper preintervention eGFR slope and determining the kidney protective potential of new therapies particularly in those participants,” the researchers wrote.
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