← SGLT2 inhibitors × cardiovascular events

TrialThe New England journal of medicine2019

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy.

Vlado Perkovic et al.PubMed ↗Publisher ↗

The primary results report of NCT02065791. Its numbers are set against the trial’s posted results below.

  • Canagliflozinlooks good hereLower renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes, fewer cardiovascular death, myocardial infarction, or stroke, lower hospitalization for heart failure.Randomised, large.

What the trial testedrandomised · 4,401 people · 2019

Randomised vs placebo

Lowered renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes

Doesn’t vote: same as the registry's posted result, which counts instead

−34%−47% to −19%

canagliflozin vs placebo

Bigger than 8 in 10 for cardiovascular events

As reported

HR 0.66, 95% CI 0.53–0.81

Randomised vs placebo

Reduced cardiovascular death, myocardial infarction, or stroke

Doesn’t vote: same as the registry's posted result, which counts instead

−20%−33% to −5%

canagliflozin vs placebo

Bigger than 4 in 10 for cardiovascular events

As reported

HR 0.80, 95% CI 0.67–0.95

Randomised vs placebo

Lowered hospitalization for heart failure

Doesn’t vote: same as the registry's posted result, which counts instead

−39%−53% to −20%

canagliflozin vs placebo

Bigger than 8 in 10 for cardiovascular events

As reported

HR 0.61, 95% CI 0.47–0.80

Not counted

Lowered end-stage kidney disease

−32%−46% to −14%

canagliflozin vs placebo

Bigger than 7 in 10 on the map

As reported

HR 0.68, 95% CI 0.54–0.86

Against the trial’s posted results

  • Same as the trial’s posted resultThis paper HR 0.66 (0.53–0.81)Posted HR 0.66 (0.53–0.81), p <0.0001Renal Composite Endpoint
  • Same as the trial’s posted resultThis paper HR 0.80 (0.67–0.95)Posted HR 0.80 (0.67–0.95), p = 0.0121Major Adverse Cardiac Event (MACE)
  • Same as the trial’s posted resultThis paper HR 0.61 (0.47–0.80)Posted HR 0.61 (0.47–0.80), p = 0.0003Hospitalized Heart Failure (HHF)
  • Same as the trial’s posted resultThis paper HR 0.70 (0.59–0.82)Posted, primary outcome HR 0.70 (0.59–0.82), p < 0.0001Primary Composite Endpoint of Doubling of Serum Creatinine (DoSC), End-stage Kidney Disease (ESKD), and Renal or Cardiovascular (CV) Death

Who was studied, and how

4,401people with cardiovascular disease, in this paper

The trial randomly assignedassigned by chance

canagliflozin
placebo

Lowered renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes−34%

Reduced cardiovascular death, myocardial infarction, or stroke−20%

Lowered hospitalization for heart failure−39%

randomised

the abstract, start to end

… causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; …

… 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; …

← favours treatmentfavours comparator →
could be chance
Renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causescanagliflozin vs placebo
HR 0.660.53–0.81
End-stage kidney diseasecanagliflozin vs placebo
HR 0.680.54–0.86
Cardiovascular death, myocardial infarction, or strokecanagliflozin vs placebo
HR 0.800.67–0.95
Hospitalization for heart failurecanagliflozin vs placebo
HR 0.610.47–0.80
SGLT2 inhibitorsCardiovascular eventsKidney outcomes
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Full record →Abstract, authors, funding and every citing paper · PMID 30990260