Diabetes Drug May Reduce CV Risk

The diabetes drug canagliflozin can help reduce the risk of cardiovascular (CV) events in type 2 diabetes patients, according to 2 recent drug trials. However, the drug can also increase patients’ risk of toe or metatarsal amputation.

The results of the trials were presented yesterday at the American Diabetes Association’s 77th Scientific Sessions.
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For the Canagliflozin Cardiovascular Assessment Study (CANVAS) Program, the researchers conducted and pooled data from 2 sister trials that evaluated 10,142 patients with type 2 diabetes and high CV risk. Patients were randomly assigned to receive either canagliflozin or placebo, and were assessed for 188.2 weeks on average.

Participants were an average age of 63.3 years, and 35.8% were women. Each participant had had diabetes for an average of 13.5 years, and 65.6% of participants had had a history of CV disease.

The primary outcomes of the trials were death from CV causes, nonfatal myocardial infarction, or nonfatal stroke.

Results showed that patients using canagliflozin had a reduced risk of the above primary outcomes, compared with those receiving placebo.

The researchers observed several additional benefits in participants taking canagliflozin, including the ability to treat the progression of albuminuria and that the estimated glomerular filtration rate, the need for renal-replacement therapy, or death from renal causes could be reduced as much as 40%.

Adverse reactions included increased risk of amputation, usually at the level of the toe or metatarsal.

“In two trials involving patients with type 2 diabetes and an elevated risk of cardiovascular disease, patients treated with canagliflozin had a lower risk of cardiovascular events than those who received placebo but a greater risk of amputation, primarily at the level of the toe or metatarsal,” the researchers concluded.

---Christina Vogt

Reference:

Neal B, Perkovic V, Mahaffey KW, et al Canagliflozin and cardiovascular and renal events in type 2 diabetes [Published online June 12, 2017]. N Engl J Med. doi: 10.1056/NEJMoa1611925.