East Asian patients reap renal, cardiovascular benefit from canagliflozin

Canagliflozin reduces the risk of renal and cardiovascular (CV) events in East Asian (EA) patients with type 2 diabetes who are at high risk of renal complications, reports a recent study.

Researchers performed a posthoc analysis of the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial, comparing the 604 participants from EA countries to non-EA patients. The canagliflozin and placebo arms had 301 and 303 EA patients, respectively. The outcome was a composite of end-stage kidney disease, renal or CV death, and doubling of the serum creatinine (DoSC).

Renal events occurred significantly more frequently in EA vs non-EA participants, including the primary composite outcome (hazard ratio [HR], 1.92, 95 percent confidence interval [CI], 1.40–2.65) and a composite of dialysis, kidney transplantation, or renal death (HR, 2.44, 95 percent CI, 1.57–3.79).

Nevertheless, canagliflozin treatment was able to suppress the risk of developing the primary outcome as opposed to placebo (40.83 vs 73.45 per 1,000 patient-years; HR, 0.54, 95 percent CI, 0.35–0.84).

Canagliflozin likewise yielded significant CV benefits over placebo, reducing the likelihood of outcomes such as the composite of CV death or hospitalization for heart failure (HHF); of CV death, myocardial infarction, or stroke; and of CV death, myocardial infarction, stroke, HHF, or unstable angina.

For both renal and CV outcomes, findings in EA patients were consistent with that in their non-EA comparators.

“These results indicate that canagliflozin reduces the risk of renal and CV events across a diverse group of participants with type 2 diabetes mellitus and albuminuria, including EA participants who are at high risk for renal complication,” the researchers said.