Canagliflozin could reduce the risk of kidney failure and cardiovascular events in patients with type 2 diabetes (T2D) and albuminuric chronic kidney disease, according to new findings from the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial.
The double-blind randomised trial recruited 4,401 patients from 34 countries. Patients were randomised to receive the oral SGLT2 inhibitor canagliflozin at a dose of 100 mg daily or placebo, in addition to either angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB). The primary outcome was a composite of end-stage kidney disease, doubling of serum creatinine levels from baseline for at least 30 days, or renal or cardiovascular death. Median follow-up was at 2.62 years.
The trial identified a 30 per cent lower relative risk of the primary composite outcome in the canagliflozin group than in the placebo group. Patients in the canagliflozin group also had a lower risk of hospitalisation for heart failure and a composite of cardiovascular death, myocardial infarction or stroke.
Lead author Professor Vlado Perkovic, of The George Institute for Global Health, described the trial result as “a major medical breakthrough”.
The trial results are published in the New England Journal of Medicine.