Relative and Absolute Risk Reductions in Cardiovascular and Kidney Outcomes With Canagliflozin Across KDIGO Risk Categories: Findings From the CANVAS Program

Rationale & Objective Canagliflozin reduces the risk for cardiovascular and kidney outcomes in type 2 diabetes. This study aimed to assess relative absolute effects of canagliflozin on clinical across different KDIGO (Kidney Disease: Improving Global Outcomes) categories based estimated glomerular filtration rate (eGFR) urinary albumin-creatinine ratio. Study Design Post hoc analysis CANagliflozin cardioVascular Assessment (CANVAS) Program. Settings Participants The CANVAS Program randomly assigned 10,142 participants with diabetes at high eGFR ? 30 mL/min/1.73 m2 treatment or placebo. Intervention(s) matching Outcomes primary outcome was a composite death, nonfatal myocardial infarction, stroke, set other prespecified outcomes. Results Of participants, 10,031 (98.9%) had available baseline ratio data. proportion low-, moderate-, high-, very high–risk 58.6%, 25.8%, 10.6%, 5.0%, respectively. effect (HR, 0.86; 95% CI, 0.75-0.97) consistent (P trend = 0.2), similar results Absolute reductions were greater within higher 0.03) pattern death hospitalization heart failure 0.06) chronic slope 0.04). Limitations Predominantly low population, relatively few categories, exclusion individuals < m2. Conclusions Although are likely risk. classification system may be able identify who might derive benefits end-organ protection from canagliflozin. Funding post not specifically funded. original trials funded by Janssen Research Development, LLC conducted as collaboration between funder, an academic steering committee, research organization, George Clinical. Trial Registration registered ClinicalTrials.gov numbers NCT01032629 NCT01989754.