Canagliflozin blunts end-stage renal disease risk in T2DM patients with CKD

In patients with type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD), treatment with canagliflozin safely decreases the risk of developing end-stage renal disease, reports a new Japan study.

Researchers conducted a multicentre, randomized, double-blinded, placebo-controlled study with 308 patients, who were randomly assigned to receive either 100-mg canagliflozin (n=154) or a placebo control (n=154). Treatments were taken once daily for 104 weeks, after which the primary efficacy endpoint of a 30-percent drop in estimated glomerular filtration rate (eGFR) was assessed.

A total of 251 participants completed 104 weeks of intervention. The proportion of canagliflozin-treated patients achieving the primary endpoint was 18.2 percent, as opposed to 29.5 percent in placebo counterparts. The intergroup point estimate difference was 11.3 percent, which was statistically significant (p=0.029).

Similarly, more patients in the placebo arm saw a 40-percent decline in eGFR, though the between-group difference was nominal (point estimate, 3.8 percent; p=0.343). Moreover, the composite endpoint of end-stage renal disease, renal death, cardiovascular death, or doubling of serum creatinine was numerically lower in the canagliflozin group (hazard ratio, 0.60; p=0.293).

In terms of safety, canagliflozin did not induce a significantly higher rate of side effects than placebo (92.9 percent vs 90.9 percent). Serious adverse events likewise arose at comparable frequencies between groups (27.9 percent vs 21.4 percent).