Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes
PBN-AR
Instytucja
Instytut Medycyny Doświadczalnej i Klinicznej im. Mirosława Mossakowskiego Polskiej Akademii Nauk
Źródłowe zdarzenia ewaluacyjne
Informacje podstawowe
Główny język publikacji
en
Czasopismo
New England Journal of Medicine (50pkt w roku publikacji)
ISSN
0028-4793
EISSN
Wydawca
MASSACHUSETTS MEDICAL SOC
DOI
URL
Rok publikacji
2017
Numer zeszytu
7
Strony od-do
644-657
Numer tomu
377
Identyfikator DOI
Liczba arkuszy
1,21
Słowa kluczowe
en
INTENSIVE GLUCOSE CONTROL
ATRIAL-NATRIURETIC-PEPTIDE
BASE-LINE CHARACTERISTICS
PLACEBO-CONTROLLED TRIAL
STAGE KIDNEY-DISEASE
METAANALYSIS
OUTCOMES
PROGRESSION
INHIBITORS
RATIONALE
Open access
Tryb otwartego dostępu
Inne
Wersja tekstu w otwartym dostępie
Wersja opublikowana
Licencja otwartego dostępu
Creative Commons — Uznanie autorstwa
Czas opublikowania w otwartym dostępie
Razem z publikacją
Data udostępnienia w sposób otwarty
Streszczenia
Język
en
Treść
BACKGROUND Canagliflozin is a sodium-glucose cotransporter 2 inhibitor that reduces glycemia as well as blood pressure, body weight, and albuminuria in people with diabetes. We report the effects of treatment with canagliflozin on cardiovascular, renal, and safety outcomes. METHODS The CANVAS Program integrated data from two trials involving a total of 10,142 participants with type 2 diabetes and high cardiovascular risk. Participants in each trial were randomly assigned to receive canagliflozin or placebo and were followed for a mean of 188.2 weeks. The primary outcome was a composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. RESULTS The mean age of the participants was 63.3 years, 35.8\% were women, the mean duration of diabetes was 13.5 years, and 65.6\% had a history of cardiovascular disease. The rate of the primary outcome was lower with canagliflozin than with placebo (occurring in 26.9 vs. 31.5 participants per 1000 patient-years; hazard ratio, 0.86; 95\% confidence interval [CI], 0.75 to 0.97; P< 0.001 for noninferiority; P = 0.02 for superiority). Although on the basis of the prespecified hypothesis testing sequence the renal outcomes are not viewed as statistically significant, the results showed a possible benefit of canagliflozin with respect to the progression of albuminuria (hazard ratio, 0.73; 95\% CI, 0.67 to 0.79) and the composite outcome of a sustained 40\% reduction in the estimated glomerular filtration rate, the need for renal-replacement therapy, or death from renal causes (hazard ratio, 0.60; 95\% CI, 0.47 to 0.77). Adverse reactions were consistent with the previously reported risks associated with canagliflozin except for an increased risk of amputation (6.3 vs. 3.4 participants per 1000 patient-years; hazard ratio, 1.97; 95\% CI, 1.41 to 2.75); amputations were primarily at the level of the toe or metatarsal. CONCLUSIONS In two trials involving patients with type 2 diabetes and an elevated risk of cardiovascular disease, patients treated with canagliflozin had a lower risk of cardiovascular events than those who received placebo but a greater risk of amputation, primarily at the level of the toe or metatarsal.
Cechy publikacji
discipline:Medycyna
discipline:Medicine
Original article
Original article presents the results of original research or experiment.
Oryginalny artykuł naukowy
Oryginalny artykuł naukowy przedstawia rezultaty oryginalnych badań naukowych lub eksperymentu.
Inne
System-identifier
PBN-R:890074
CrossrefMetadata from Crossref logo
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