Canagliflozin reduces proteinuria by targeting hyperinsulinaemia in diabetes patients with heart failure: A post hoc analysis of the CANDLE trial
Authors' conclusion
In patients with T2DM and CHF, regression of proteinuria with canagliflozin treatment was associated with the pretreatment insulin level. These results may provide clinicians with novel mechanistic insights into the beneficial effects of canagliflozin on renal outcomes and may warrant discussion for selecting preferred patient profiles, including pretreatment insulin levels.
Study context
- Population
- Patients with T2D and chronic heart failure
- Participants
- 102 vs 112
- Comparison
- Canagliflozin vs glimepiride for 24 weeks
- Canagliflozinn = 102
- Glimepiriden = 112reference
- Primary endpoint
- Factors associated with regression of proteinuria
- Follow-up
- 24 weeks
Methodological detailsmultivariate logistic models
- Multivariate logistic models
Primary result
As reported in the abstract
Higher baseline insulin, per 1-mlU/L increase, solely associated with proteinuria regression: OR (P = .011)
1.24
1.05–1.47
Further findings
Regression of proteinuria · 24 weeks · regression higher, progression lower with canagliflozin
P = 0.0001
Progression of proteinuria · 24 weeks
Change in eGFR category
- No differences between groups
Insulin, HOMA-β, HOMA-IR and estimated plasma volume · 24 weeks
- Decreased in the regression subclass but not in the progression subclass
Original publication
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