The renal and cardiovascular results of the CREDENCE study: implications for the clinical practice

Czech version

Authors: Zbynek Schroner
Authors‘ workplace: SchronerMED s. r. o., Košice
Published in: Diab Obez 2019; 19(38): 118-120
Category: Clinical studies

Overview

CREDENCE (Canagliflozin in Renal Events in Diabetes with Established Nephropathy) was randomized, double-blind, placebo-controlled study with the aim assessing effect of SGLT2 inhibitor –⁠ canagliflozin 100 mg in comparison with placebo on renal outcomes in patients with diabetic nephropathy in chronic kidney disease (CKD) stages 2–3b. Before randomisation all patients had to be treated with the renin-angiotensin system blocker in order to find out add-on effect of canagliflozin on progression of CKD. Canagliflozin reduced risk of primary renal outcome (doubling of the serum creatinine level, end-stage kidney disease, death from renal or cardiovascular /CV/ causes) by 30 % s placebo. Canagliflozin vs placebo also decreased some secondary outcomes, composit CV outcome (CV mortality, nonfatal myocardial infarction and stroke) by 20 %. There were no significant differences in rate of amputations or fractures between canagliflozin vs placebo.

Keywords:

canagliflozin – diabetic nephropathy – study CREDENCE – type 2 diabetes treatment

Sources

Zinman B, Wanner C, Lachin JM et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med 2015; 373(22): 2117–2128. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1504720>.
Neal B, Perkovic V, Mahaffey KW et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med 2017; 377(7): 644–657. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1611925>.
Wiviott SD, Raz I, Bonaca P et al. Dapagliflozin and cardiovascular outcomes in type 2 diabetes. N. Eng J Med 2019; 380(4): 347–357. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1812389>.
Perkovic V, Jardine MJ, Neal B et al. Canagliflozin and renal outcomes in type 2 diabetes and nephropathy. N Engl J Med 2019; 380(24): 2295–2306. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1811744>.
Tkáč I. Výsledky štúdie CREDENCE (Canagliflozin in Renal Events in Diabetes with Established Nephropathy) a jej možné implikácie pre klinickú prax. Interná Med 2019; 19(4): 125–127.
Mahaffey KW, Jardine MJ, Bompoint S et al. Canagliflozin and cardiovascular and renal outcomes in type 2 diabetes mellitus anch chronic kidney disease in primary and secondary cardiovascular prevention groupos, results from the randomized CREDENCE trial. Circulation 2019; 140(9): 739–750. Dostupné z DOI: <http://dx.doi.org/10.1161/CIRCULATIONAHA.119.042007>.
Mokáň M, Okša A, Galajda P. Nefroprotektívny účinok gliflozínov u pacientov s diabetickou obličkovou chorobou –⁠ výsledky štúdie CREDENCE. Interná Med 2019; 19(9): 325–328.
Davies MJ, D Alessio DA, Fradkin J et al. Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia 2018; 61(12). 2461–2498. Dostupné z DOI: <https://doi.org/10.1007/s00125–018–4729–5>.
Martinka M, Uličiansky BV, Mokáň M et al. Konsenzuálne terapeutické odporúčanie Slovenskej diabetologickej spoločnost pre diabetes mellitus 2. typu (2018). A consensual therapeutic recommendation for type 2 diabetes mellitus by the Slovak Diabetes Society (2018). Forum Diab 2018; 7(1). 47–68.