The CREDENCE study sought to compare the efficacy of canagliflozin vs. placebo in preventing clinically-relevant kidney and cardiovascular events in patients with diabetes and established kidney disease. With regard to the primary endpoint (terminal kidney failure; doubling of creatinine; renal or cardiovascular death), the authors reported a 30% reduction in the relative risk (hazard ratio [HR]: 0.70; 95% CI: 0.59-0.82, p=0.00001) after 2.6 years of follow-up. The risk was reduced by 17-39% with regard to secondary cardiovascular or renal endpoints. These results should be integrated in our therapeutic approach for Type 2 diabetes patients, in terms of both nephro- and cardioprotection.
What does this article bring up for us?
Previous studies with gliflozins have demonstrated cardiovascular and renal benefits, in addition to the glycemic improvement in Type 2 diabetic subjects, with a “near-normal” renal function observed in the majority of patients (eGF :74-85mL/min/1.7 m2 [mean]). CREDENCE reports new original data collected from diabetic patients with preexisting renal failure (eGFR: 56 mL/min/1.73 m2) treated with canagliflozin vs. placebo.
Key Words
Canagliflozin, type 2 diabetes, renal failure, nephroprotection, cardioprotection