September 2022

Effect of Canagliflozin on Total Cardiovascular Burden in Patients With Diabetes and Chronic Kidney Disease: A Post Hoc Analysis From the CREDENCE Trial

J Am Heart Assoc 2022;11:e025045 DOI: 10.1161/JAHA.121.025045

Cardiovascular disease is highly prevalent, and represents a major burden in patients with both T2D and CKD. In the CREDENCE trial, canagliflozin reduced the risk of first composite cardiovascular events; this post hoc analysis evaluated the effect on total (first and recurrent) events. During the trial, a total of 883 cardiovascular events occurred in 634 patients; 72% were first and 28% were subsequent events. Analysis showed canagliflozin reduced first and total cardiovascular events by 26% and 29%, respectively, with consistent results across patient subgroups and by baseline cardiovascular history.

These findings provide further support for the benefit of continuing canagliflozin therapy after an initial event to prevent recurrent CV events.

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Iron Deficiency in Heart Failure and Effect of Dapagliflozin: Findings From DAPA-HF

Circulation 2022; online ahead of print DOI: 10.1161/CIRCULATIONAHA.122.060511

In this post hoc analysis of DAPA-HF, 43.7% of participants had iron deficiency at baseline, which was associated with worse outcomes. Dapagliflozin appeared to increase iron use but improved outcomes, irrespective of iron status at baseline.

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July 2022

Empagliflozin and Incidence of Events Consistent With Acute Kidney Injury: Pooled Safety Analysis in More Than 15,000 Individuals

Diabetes Obes Metab 2022;24:1390-3 doi: 10.1111/dom.14694

In this pooled analysis of patients from the global empagliflozin trial programme, the risk of acute kidney injury (AKI) and acute kidney disease (AKD) with empagliflozin was comparable with placebo. This comprehensive analysis indicates that empagliflozin is not associated with an increased risk of acute kidney failure compared with placebo treatment.

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Effects of Canagliflozin Versus Finerenone on Cardiorenal Outcomes: Exploratory Post Hoc Analyses From FIDELIO-DKD Compared to Reported CREDENCE Results

Nephrol Dial Transplant 2022;37:1261-9 doi.org/10.1093/ndt/gfab336

This analysis highlights the pitfalls of direct comparisons between trials, since when key differences in design are considered, FIDELIO-DKD and CREDENCE demonstrate similar cardiorenal benefits. The authors conclude that both canagliflozin and finerenone are similarly effective in reducing the risk of cardiorenal outcomes.

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May 2022

Effects of canagliflozin on Myocardial Infarction: A Post Hoc Analysis of the CANVAS Programme and CREDENCE Trial

Cardiovasc Res 2022;118:1103–14

Yu et al. report that canagliflozin is not associated with a reduction in overall myocardial infarction in the pooled CANVAS and CREDENCE population. The CANVAS cohort found a possible differential effect on ST-elevation myocardial infarction (STEMI) and non-STEMI warranting further investigation.

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The Comparative Cardiovascular and Renal Effectiveness of Sodium-Glucose Co-Transporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists: A Scandinavian Cohort Study

Diabetes Obes Metab 2022;24:473–85 doi: 10.1111/dom.14598

In this study by Ueda et al., SGLT2 inhibitors were associated with a similar risk of heart failure and a lower risk of serious renal events compared with GLP-1 receptor agonist,s and the use of GLP-1 receptor agonists was associated with a slightly lower risk of MACE compared with SGLT2 inhibitors.

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Effect of the Glucagon-Like Peptide-1 Receptor Agonists Semaglutide and Liraglutide on Kidney Outcomes in Patients With Type 2 Diabetes: Pooled Analysis of SUSTAIN 6 and LEADER

Circulation 2022;145:575–85 doi: 10.1161/CIRCULATIONAHA.121.055459

In this analysis by Shaman et al., semaglutide and liraglutide offered kidney-protective effects in patients with type 2 diabetes, especially those with pre-existing chronic kidney disease.

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