1. Evaluating the Effects of Canagliflozin on Cardiovascular and Renal Events in Patients With Type 2 Diabetes Mellitus and Chronic Kidney Disease According to Baseline HbA1c, Including Those With HbA1c <7%: Results From the CREDENCE Trial.
- Author
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Cannon, Christopher P., Perkovic, Vlado, Agarwal, Rajiv, Baldassarre, James, Bakris, George, Charytan, David M., de Zeeuw, Dick, Edwards, Robert, Greene, Tom, Heerspink, Hiddo J.L., Jardine, Meg J., Levin, Adeera, Li, Jing-Wei, Neal, Bruce, Pollock, Carol, Wheeler, David C., Zhang, Hong, Zinman, Bernard, and Mahaffey, Kenneth W.
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TYPE 2 diabetes , *CHRONIC kidney failure , *CARDIOVASCULAR diseases , *DIABETIC nephropathies , *CANAGLIFLOZIN , *CONTINUING medical education , *MEDICAL research , *RESEARCH , *KIDNEYS , *RESEARCH methodology , *HYPOGLYCEMIC agents , *EVALUATION research , *MEDICAL cooperation , *CARDIOVASCULAR system , *COMPARATIVE studies , *RANDOMIZED controlled trials , *STATISTICAL sampling , *PHARMACODYNAMICS , *DISEASE complications ,CHRONIC kidney failure complications - Abstract
Keywords: canagliflozin; chronic kidney disease; diabetes mellitus, type 2; SGLT2 inhibitors EN canagliflozin chronic kidney disease diabetes mellitus, type 2 SGLT2 inhibitors 407 410 4 04/20/20 20200204 NES 200204 Traditional management of diabetes mellitus has focused on glycemic control, beginning with lifestyle changes, followed by metformin, and then other classes of antiglycemic agents.[1] Sodium glucose co-transporter 2 inhibitors reduce cardiovascular events, including cardiovascular death, myocardial infarction, and heart failure, and slow the progression of renal dysfunction, including prevention of end-stage kidney disease.[2],[3] Because initial clinical trials included mostly patients with baseline HbA1c >7%, current guidelines have recommended this class of drugs as an add-on therapy for patients whose HbA1c is not at goal, typically >=7%.[1] We hypothesized that there would be similar benefits on cardiovascular and renal end points regardless of baseline HbA1c, including those with HbA1c <7%. We found that canagliflozin reduced the risk of both cardiovascular and renal events in patients with type 2 diabetes mellitus and chronic kidney disease without a significant interaction across the spectrum of baseline HbA1c values, which included patients with baseline HbA1c between 6.5% and 7%, suggesting that treatment of patients with chronic kidney disease or atherosclerotic cardiovascular disease is warranted, even if their diabetes mellitus is "well controlled.". [Extracted from the article]
- Published
- 2020
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