Canagliflozin Cuts Hospitalization Risk for HF in Type 2 Diabetes Patients

The CANVAS Program is the longest, largest and broadest completed CV outcomes program of any SGLT2 inhibitor to date
The CANVAS Program is the longest, largest and broadest completed CV outcomes program of any SGLT2 inhibitor to date

Canagliflozin (Invokana; Janssen) significantly decreased the risk of hospitalization for heart failure (HHF) in patients with type 2 diabetes, according to data from the CANVAS Program presented at the American College of Cardiology's 67th Annual Scientific Session.

Canagliflozin, a sodium-glucose co-transporter 2 (SGLT2) inhibitor, is currently approved as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes. For this study, researchers aimed to assess heart failure (HF) outcomes in patient subgroups, especially among those with or without heart failure at baseline.

In the CANVAS Program (N=10,142), patients with type 2 diabetes with high cardiovascular risk were randomized to receive canagliflozin or placebo for an average of 188 weeks; 14% (N=1461) of these patients had a prior diagnosis of HF at baseline.

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Results showed that treatment with canagliflozin reduced the risk of cardiovascular death or HHF by 22% (hazard ratio 0.78, 95% CI: 0.67–0.91) and fatal or hospitalized HF by 30% (HR 0.70, 95% CI: 0.55–0.89). The risk of HHF alone was reduced by 33% vs placebo (HR 0.67, 95% CI: 0.52–0.87) with the effects being comparable across various subgroups (ie, age, gender, history of myocardial infarction, or baseline use of diuretics, beta-blockers, or RAAS blockade.) 

In addition, the number needed to treat (NNT) to prevent 1 HF event in 5 years among those with prior history of HF was found to be smaller compared to those without prior history (1 in 14 vs 1 in 144, respectively).  "The ~10-fold improvement in NNT in patients with a prior HF diagnosis may have implications for targeting of therapy in patients with diabetes," the authors write.

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Reference:

Figtree G, Rådholm K, Solomon S, et al. Canagliflozin For Prevention Of Heart Failure In Type 2 Diabetes: Results From The CANVAS Program. Presented at: ACC.18 Scientific Sessions & Expo. March 10–12, 2018; Orlando, FL. Abstract #407-10.