The CANVAS Trial - Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes

Title: Renal Events in Type 2 Diabetes

Design: multicenter, randomized, double-blind, placebo-controlled trial

Objective: does daily canagliflozin reduce CV mortality, nonfatal MI, or nonfatal strokes when compared to placebo in patients with type ii diabetes?

N=1000

Year of publication: 2017

Inclusion Criteria: Type II DM patients (HbA1c ≥7.0% to ≤10.5%), not on active DM treatment with documented symptomatic atherosclerotic CV disease or high risk for CVD

Comparison groups: CANAGLIFLOZIN 100-300 mg dose N = 5795 Event per 1000 patient-years placebo N = 4347

Primary Outcome:

  • CV mortality, nonfatal MI, or nonfatal stroke HR 0.86 (0.75 to 0.97) P<0.001 for noninferiority; 26.9 vs 31.5 P=0.02 for superiority

Secondary Outcome:

  • All-cause mortality HR 0.87; 95% CI 0.74 to 1.01; 17.3 vs 19.5 P = NS
  • Hospitalization for heart failure 5.5 vs 8.7 HR 0.67; 95% CI, 0.52 to 0.87

Conclusion: canagliflozin reduces risk of cardiovascular events, renal decline, hf hospitalizations but increases risk of amputations in type II dm with high cv risk

Source: N Engl J Med 2017; 377:644-657 |