SAN DIEGO — The sodium–glucose cotransporter 2 (SGLT2) inhibitor canagliflozin (Invokana, Janssen Pharmaceuticals) reduces cardiovascular events by 14% and cuts the rate of renal decline by 40% but also doubles the risk for lower-limb amputation, new cardiovascular-outcomes trial data indicate.
Combined results from the Canagliflozin Cardiovascular Assessment Study (CANVAS) and the CANVAS renal-end-points trial (CANVAS-R) were presented here at the American Diabetes Association (ADA) 2017 Scientific Sessions today and were simultaneously published in the New England Journal of Medicine.
These data represent the second time cardiovascular benefit has been demonstrated in a US Food and Drug Administration–mandated cardiovascular outcomes trial for an SGLT2 inhibitor, with the first being the landmark Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME), which demonstrated a major reduction in both all-cause and cardiovascular death among high-risk patients taking empagliflozin (Jardiance, Boehringer Ingelheim/Lilly) in September 2015.
Dr Bruce Neal
Now, the CANVAS data suggest that cardiovascular and renal benefits are a class effect, lead investigator Bruce Neal, MB, ChB, PhD, professor of medicine, University of New South Wales Sydney, and senior director, the George Institute for Global Health, Sydney, Australia, told Medscape Medical News.
"Here's a second drug with clear protection. Things bounce around in terms of the individual outcomes, as you'd expect with relatively small numbers, but I think it will be viewed — and should be viewed — as a big piece of new evidence that basically says this is a great class of drugs for people with diabetes."
