Follow-up assessments of two large studies of canagliflozin show that the drug has more widespread benefits for kidney patients than previously thought, both in terms of kidney protection and lowering the risk of peripheral artery disease. The studies report that even patients with mild kidney disease or no history of cardiovascular disease benefit from the medication.
Canagliflozin belongs to a class of medication called SGLT2 inhibitors. Two large clinical trials, called CANVAS and CREDENCE, have confirmed the drug can help slow kidney disease progression in people with diabetes. However, these initial studies did not explore whether certain subgroups of patients benefit from the therapy too.
Therefore, investigators conducted a follow-up study, published in Diabetes Obesity and Metabolism, re-assessing the CANVAS and CREDENCE data by different subgroups of patients based on their kidney function and risk of disease progression. Results show the overall risk for kidney disease progression was 37% lower for people taking canagliflozin compared to those taking a placebo, regardless of whether a person had mild or severe kidney impairment at the beginning of the study. This reduced risk of kidney disease progression was sustained until the end of the trials, 18 months later.
In the second study, also published in Diabetes Obesity and Metabolism, the same data was re-assessed to determine whether canagliflozin was beneficial in terms of lowering patients’ risk of peripheral artery disease. The results show that canagliflozin significantly reduced the risk of cardiovascular death, non-fatal heart attack and non-fatal stroke by 14% in the overall cohort, and 18% in patients with established cardiovascular disease.
“These results show that canagliflozin is a beneficial drug whether you do or don’t have peripheral artery disease at baseline, and for patients with any degree of kidney disease,” says Dr. Adeera Levin, department head of the Division of Nephrology at the University of British Columbia, and executive director of BC Renal, who was involved in the follow up studies.
She also notes that – importantly – the drug was found to be effective irrespective of a person’s blood sugar control. “People think of these drugs as lowering blood sugar, but they do much more than that,” emphasizes Levin, noting that additional studies to better understand the effects of canagliflozin are ongoing.