In addition to its ability to reduce glucose and blood pressure, canagliflozin might reduce the risk for the development of anemia and initiation of anemia treatments in patients who have type 2 diabetes and chronic kidney disease, new study findings indicate.

In a post hoc analysis of the CREDENCE (Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation) trial, canagliflozin treatment was associated with a greater mean hemoglobin increase of 7.1g/L and a greater hematocrit increase of 2.4% compared with placebo during a median 2.6 years.

Further, the risk for a composite outcome of anemia events or anemia treatment was a significant 35% lower among patients receiving canagliflozin, a sodium glucose cotransporter 2 inhibitor, compared with placebo, Hiddo Lambers Heerspink, PhD, of the University Medical Center Groningen in Groningen, the Netherlands, and colleagues reported in The Lancet: Diabetes & Endocrinology. The canagliflozin group also had significant 42%, 36%, and 35% lower risks for anemia events alone, initiation of iron therapy, and need for erythropoiesis-stimulating agents (ESA), respectively, compared with the placebo arm, the investigators reported.

At baseline, 1599 (36%) of all 4401 patients had anemia (hemoglobin less than 130g/L in men or less than 120g/L in women), and 33 patients (less than 1%) used ESAs. During follow-up, 573 patients had an investigator-reported anemia event or initiated anemia treatment, of whom 358 (8%) had anemia events, 343 (8%) initiated iron preparations, 141 (3%) initiated ESAs, and 114 (2%) received blood transfusions.


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“In addition to the benefits for kidney and cardiovascular outcomes, the available evidence suggests that canagliflozin might reduce the risk of anaemia and minimise the need for erythropoiesis-stimulating agents and other treatments for anaemia in patients with type 2 diabetes and chronic kidney disease,” Dr Heerspink’s team concluded.

As this study was post hoc and anemia was not a prepecified endpoint, prospective research is needed to confirm the findings.

Disclosure: This clinical trial was supported by Janssen Research and Development. Please see the original reference for a full list of authors’ disclosures.

Reference

Oshima M, Neuen BL, Jardine MJ, et al. Effects of canagliflozin on anaemia in patients with type 2 diabetes and chronic kidney disease: a post-hoc analysis from the CREDENCE trial. Lancet Diabetes Endocrinol. 2020;8:903-914. doi:10.1016/S2213-8587(20)30300-4

This article originally appeared on Renal and Urology News