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.

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.