Back to Search
Start Over
The impact of canagliflozin on the risk of neuropathy events: A post-hoc exploratory analysis of the CREDENCE trial.
- Source :
-
Diabetes & metabolism [Diabetes Metab] 2022 Jul; Vol. 48 (4), pp. 101331. Date of Electronic Publication: 2022 Feb 13. - Publication Year :
- 2022
-
Abstract
- Aim: Canagliflozin reduces the risk, and progression, of diabetic kidney disease. We hypothesized that it may improve the microvascular complication of neuropathy.<br />Methods: The CREDENCE trial randomized participants with type 2 diabetes and kidney disease to canagliflozin 100 mg daily or placebo. Neuropathy events were defined post-hoc as any reported adverse event consistent with a peripheral or autonomic neuropathy event. The effect of canagliflozin and predictors of neuropathy events were estimated using Cox regression analysis. In sensitivity analyses the endpoint was restricted to sensorimotor polyneuropathy, diabetic neuropathy, and non-autonomic neuropathy events.<br />Results: Almost half (48.8%) of the 4401 participants had a diagnosis of neuropathy at baseline. Over a median of 2.45 years of follow up, 657 people experienced a neuropathy event (63.2 per 1000 patient-years). Independent factors associated with higher risk of experiencing neuropathy events were non-white race, younger age, higher glycated haemoglobin and lower estimated glomerular filtration rate. The incidence of neuropathy events was similar in people randomized to canagliflozin and placebo (334/2202 vs. 323/2199; HR 1.04, 95% CI 0.89 to 1.21, P = 0.66). Canagliflozin had no impact on sensorimotor polyneuropathy (HR 0.93, 95% CI 0.69 to 1.25, P = 0.63), diabetic neuropathy (HR 0.91, 95% CI 0.68 to 1.22, P = 0.52), or non-autonomic neuropathy (HR 1.03, 95% CI 0.87 to 1.21, P = 0.77). The lack of effect on neuropathy events was consistent in subgroup analyses.<br />Conclusion: Canagliflozin did not affect the risk of neuropathy events in the CREDENCE trial. Future large randomized studies with prespecified neuropathy endpoints are required to determine the impact of sodium glucose cotransporter 2 inhibitors on diabetic neuropathy.<br />Competing Interests: Conflicts of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)
- Subjects :
- Canagliflozin adverse effects
Humans
Cardiovascular Diseases epidemiology
Diabetes Mellitus, Type 2 complications
Diabetes Mellitus, Type 2 drug therapy
Diabetes Mellitus, Type 2 epidemiology
Diabetic Nephropathies drug therapy
Diabetic Neuropathies drug therapy
Diabetic Neuropathies epidemiology
Sodium-Glucose Transporter 2 Inhibitors therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1878-1780
- Volume :
- 48
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Diabetes & metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 35172198
- Full Text :
- https://doi.org/10.1016/j.diabet.2022.101331