An overview of the CANVAS Program and CREDENCE trial: The primary outcomes and key clinical implications for those managing patients with type 2 diabetes
Authors' conclusion
Canagliflozin reduced important CV, kidney and mortality outcomes in those with T2D and high CV risk or CKD across diverse patient groups, with a good safety profile. Taken together with the other sodium-glucose cotransporter-2 inhibitor CV and renal outcomes trials, these landmark findings have changed the treatment landscape for patients worldwide.
Study context
- Population
- T2D with high CV risk (CANVAS Program) or albuminuric chronic kidney disease (CKD) (CREDENCE)CANVAS 10,142
- Comparison
- Canagliflozin vs placebo
- Primary endpoint
- CANVAS: MACE; CREDENCE: composite of kidney failure, sustained doubling of serum creatinine, or death from kidney or CV causes
- Follow-up
- Median 126 weeks (CANVAS); 109 weeks (CREDENCE)
Methodological detailsevent-driven, double-blind
- Event-driven
- Double-blind
Primary result
As reported in the abstract
Primary outcomes
Canagliflozin vs PlaceboHazard ratio (95% CI)P value
CANVAS: MACE, 14% reduction
0.86(0.75–0.97)
P < 0.001CREDENCE: kidney/CV composite, 30% reduction
0.70(0.59–0.82)
P < 0.001Further findings
Hospitalization for HF
- CANVAS: HR
- 0.67 (95% CI 0.52 to 0.87)
- CREDENCE: HR
- 0.61 (95% CI 0.47 to 0.80)
- Substantial reductions in hospitalization for HF and other key CV and kidney outcomes
Subgroups by baseline age, sex, kidney function and history of CVD
- Relative clinical benefits consistent across subgroups; absolute benefits greatest in those at highest baseline risk
Safety
- Total serious adverse events less common with canagliflozin
- Amputation and fracture concerns in CANVAS not seen in CREDENCE; appear spurious chance findings
Original publication
An overview of the CANVAS Program and CREDENCE trial: The primary outcomes and key clinical implications for those managing patients with type 2 diabetes. Diabetes Obes Metab. Published 22 July 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →