1. Renal, cardiovascular and safety outcomes of canagliflozin in patients with type 2 diabetes and nephropathy in East and South-East Asian countries: Results from the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation Trial.
- Author
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Wada T, Mori-Anai K, Kawaguchi Y, Katsumata H, Tsuda H, Iida M, Arakawa K, and Jardine MJ
- Subjects
- Adult, Albuminuria blood, Albuminuria urine, Asia, Southeastern, Cardiovascular Diseases etiology, Creatinine blood, Creatinine urine, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 metabolism, Diabetic Nephropathies etiology, Diabetic Nephropathies metabolism, Double-Blind Method, Asia, Eastern, Female, Glomerular Filtration Rate drug effects, Humans, Kidney drug effects, Kidney Failure, Chronic etiology, Male, Middle Aged, Proportional Hazards Models, Treatment Outcome, Canagliflozin therapeutic use, Cardiovascular Diseases prevention & control, Diabetes Mellitus, Type 2 drug therapy, Diabetic Nephropathies drug therapy, Kidney Failure, Chronic prevention & control, Sodium-Glucose Transporter 2 Inhibitors therapeutic use
- Abstract
Aims/introduction: The sodium-glucose cotransporter 2 inhibitor, canagliflozin, reduced kidney failure and cardiovascular events in the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial. We carried out a post-hoc analysis to evaluate the efficacy and safety of canagliflozin in a subgroup of participants in East and South-East Asian (EA) countries who are at high risk of renal complications., Materials and Methods: Participants with an estimated glomerular filtration rate of 30 to <90 mL/min/1.73 m
2 and urinary albumin-to-creatinine ratio of >300-5,000 mg/g were randomized to 100 mg of canagliflozin or a placebo. The effects of canagliflozin treatment on pre-specified efficacy and safety outcomes were examined using Cox proportional hazards regression between participants from EA countries (China, Japan, Malaysia, the Philippines, South Korea and Taiwan) and the remaining participants., Results: Of 4,401 participants, 604 (13.7%) were from EA countries; 301 and 303 were assigned to the canagliflozin and placebo groups, respectively. Canagliflozin lowered the risk of primary outcome (composite of end-stage kidney disease, doubling of serum creatinine level, or renal or cardiovascular death) in EA participants (hazard ratio 0.54, 95% confidence interval 0.35-0.84). The effects of canagliflozin on renal and cardiovascular outcomes in EA participants were generally similar to those of the remaining participants. Safety outcomes were similar between the EA and non-EA participants., Conclusions: In the CREDENCE trial, the risk of renal and cardiovascular events was safely reduced in participants from EA countries at high risk of renal events., (© 2021 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)- Published
- 2022
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