Cardiorenal protective effects of canagliflozin in CREDENCE according to glucose lowering
Authors' conclusion
The glycemic effects of canagliflozin are attenuated at lower eGFR but effects on kidney and cardiac end points are preserved. Non-glycemic effects may be primarily responsible for the kidney and cardioprotective benefits of canagliflozin.22.
Study context
- Population
- Individuals with prebaseline and postbaseline hemoglobin A1c (HbA1c) in the CREDENCE trial
- Participants
- 4,395 individuals
- Comparison
- Canagliflozin vs placebo, effects according to glucose lowering
- Canagliflozinn = 2,193
- Placebon = 2,202reference
- Primary endpoint
- Combined kidney or CV death, end-stage kidney disease or doubling of serum creatinine (primary trial outcome)
Methodological detailsmediation analysis
- Mediation analysis
Primary result
As reported in the abstract
Primary outcome, with and without adjustment for achieved HbA1c
Canagliflozin vs PlaceboEstimate (95% CI)
Primary outcome, with and without adjustment for achieved HbA1c
HR (unadjusted) 0.67(0.57–0.80)
Interval as printed
HR (adjusted for week 13 HbA1c) 0.71(0.060–0.84)
Further findings
| Outcome | Estimate | |
|---|---|---|
| Kidney composite outcomeCanagliflozinvs Placebo | HR (unadjusted) 0.66 (95% CI 0.53–0.81) | |
| Kidney composite outcomeCanagliflozinvs Placebo | HR (adjusted for week 13 HbA1c) 0.68 (95% CI 0.55–0.83) | |
| 0.512Ratio (log scale) |
HbA1c change by baseline estimated glomerular filtration rate (eGFR) (mL/min/1.73 m²)
- HbA1c decrease, canagliflozin vs placebo, eGFR 60-90
- −0.24%
- HbA1c decrease, canagliflozin vs placebo, eGFR 45-59
- −0.14%
- HbA1c decrease, canagliflozin vs placebo, eGFR 30-44
- −0.08%
- >0.5% HbA1c decrease, OR, eGFR 60-90
- 1.47 (95% CI 1.27 to 1.67)
- >0.5% HbA1c decrease, OR, eGFR 45-59
- 1.12 (0.94 to 1.33)
- >0.5% HbA1c decrease, OR, eGFR 30-44
- 0.99 (0.83 to 1.18)
- HbA1c lowering was modified by baseline eGFR
Analyses adjusted for time-varying HbA1c or HbA1c as cubic spline
- Similar; preserved clinical benefits across a range of excellent and poor glycemic control
Original publication
Cardiorenal protective effects of canagliflozin in CREDENCE according to glucose lowering. BMJ Open Diabetes Res Care. Published 13 June 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →