Canagliflozin produces dramatic benefits in type 2 diabetes – reduced kidney disease and more

Type 2 diabetes contributes directly to many serious comorbidities: one of the most important of these is kidney failure worldwide. A large, industry-sponsored double-blind, randomized trial has recently assessed the impact of canagliflozin upon albuminuric chronic kidney disease in people with type 2 diabetes. Those enrolled were already affected by a decline in renal function (estimated GFR 30 – 90 ml/min/1.73 m² of BSA + albuminuria, and were already treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m²), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. The trial was stopped early after a planned interim analysis where it was discovered that the intervention dramatically lowered the relative risk of the primary outcome (30% lower) – (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). Those treated with canagliflozin also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. The results are being hailed as a game-changing finding – see the original study here