A new study examines the effects of canagliflozin, a new drug for type 2 diabetes patients, on heart and kidney disease outcomes.

Type 2 diabetes, high blood pressure, and overweight affect millions of people worldwide. Canagliflozin is a new medication that is used to treat type 2 diabetes but also has positive effects on blood pressure, weight, and kidney function and may reduce the risk of serious heart and kidney disease. In the New England Journal of Medicine, Neal and colleagues report on the CANVAS program, which was created to examine the benefits of canagliflozin and assess safety risks.

The CANVAS program took place across 30 countries and included a total of 9,734 patients with type 2 diabetes, who were randomly assigned to either canagliflozin or a placebo. Patients were followed, on average, for 3.6 years and were assessed for death from cardiovascular disease and the incidence of nonfatal heart attacks and strokes. Patients received therapy for other conditions and had similar health status at baseline.

Neal and colleagues found that significantly fewer patients on canagliflozin suffered a fatal or nonfatal heart attack or stroke. Patients on canagliflozin also had a reduced incidence of serious kidney disease and an increased regression of kidney disease, which culminated in fewer deaths related to kidney issues. Patients on canagliflozin had fewer adverse effects than those on placebo, but had a higher risk of amputation of the legs, feet, or most often, toes. This was most common among patients who had already had an amputation. There were no increased risks of other conditions such as hypoglycemia, embolism, or acute kidney injuries.

This randomized control trial shows clear benefits of canagliflozin treatment for patients with type 2 diabetes who also suffer from cardiovascular and kidney disease. These patients experience a decrease in the risk for fatal and nonfatal incidents as well as a slowing down of disease progression, probably through the lowering of blood pressure or improving blood sugar levels. However, patients who have had previous amputations may experience a risk of more amputations.

Written by C.I. Villamil

Reference: Neal, Bruce, et al. “Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes.” New England Journal of Medicine (2017).

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