Effects of Canagliflozin in Patients with Baseline eGFR <30 ml/min per 1.73 m2: Subgroup Analysis of the Randomized CREDENCE Trial.

Clinical Journal of the American Society of Nephrology : CJASN
G BakrisVlado Perkovic

Abstract

The Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial demonstrated that the sodium glucose cotransporter 2 (SGLT2) inhibitor canagliflozin reduced the risk of kidney failure and cardiovascular events in participants with type 2 diabetes mellitus and CKD. Little is known about the use of SGLT2 inhibitors in patients with eGFR <30 ml/min per 1.73 m2. The participants in the CREDENCE study had type 2 diabetes mellitus, a urinary albumin-creatinine ratio >300-5000 mg/g, and an eGFR of 30 to <90 ml/min per 1.73 m2 at screening. This post hoc analysis evaluated participants with eGFR <30 ml/min per 1.73 m2 at randomization. Effects of eGFR slope through week 130 were analyzed using a piecewise, linear, mixed-effects model. Efficacy was analyzed in the intention-to-treat population, on the basis of Cox proportional hazard models, and safety was analyzed in the on-treatment population. At randomization (an average of 29 days after screening), 174 of 4401 (4%) participants had an eGFR <30 ml/min per 1.73 m2 (mean [SD] eGFR, 26 [3] ml/min per 1.73 m2). From weeks 3 to 130, there was a 66% difference in the mean rate of eGFR decline with canagliflozin versus placebo (mean slopes, ...Continue Reading

References

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Citations

Nov 21, 2020·Clinical Journal of the American Society of Nephrology : CJASN·Sophia Zoungas, Kevan R Polkinghorne
Feb 5, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Sophia Zoungas, Ian H de Boer
Feb 11, 2021·Antioxidants·Daiji KawanamiMakito Tanabe
Mar 18, 2021·Zeitschrift für Gastroenterologie·Florian Gunnar ScurtChristos Chatzikyrkou
Mar 27, 2021·Current Opinion in Nephrology and Hypertension·Caitlyn VlasschaertSamuel A Silver
Apr 25, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Julie H IshidaCharles A Herzog
Jul 3, 2021·Journal of Clinical Medicine·Juan M BuadesNicanor Vega
Aug 8, 2021·Drugs·Lucia Del VecchioSimonetta Genovesi
Jul 18, 2021·Journal of the American Society of Nephrology : JASN·Glenn M ChertowUNKNOWN DAPA-CKD Trial Committees and Investigators

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