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SGLT2 Inhibitors Through the Windows of EMPA-REG and CANVAS Trials: A Review

EMPA-REG OUTCOME and CANVAS trials were designed to study the cardiovascular safety of empagliflozin and canagliflozin, respectively. Both studies were sufficiently powered to study the non-inferiority for cardiovascular (CV) outcomes in patients with type 2 diabetes mellitus (DM) and showed superio...

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Autores principales: Rastogi, Ashu, Bhansali, Anil
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688986/
https://www.ncbi.nlm.nih.gov/pubmed/29076040
http://dx.doi.org/10.1007/s13300-017-0320-1
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author Rastogi, Ashu
Bhansali, Anil
author_facet Rastogi, Ashu
Bhansali, Anil
author_sort Rastogi, Ashu
collection PubMed
description EMPA-REG OUTCOME and CANVAS trials were designed to study the cardiovascular safety of empagliflozin and canagliflozin, respectively. Both studies were sufficiently powered to study the non-inferiority for cardiovascular (CV) outcomes in patients with type 2 diabetes mellitus (DM) and showed superiority for major adverse cardiovascular events and composite renal outcomes independent of glycemic control. Further, all patients in EMPA-REG had prior CV events (secondary prevention), compared to CANVAS that also included subjects with no prior CV events, indicating the beneficial effects of canagliflozin in primary prevention of CV events as well. Moreover, there seems to be ethnic variations in response to sodium-glucose cotransporter 2 inhibitors (SGLT2i) regarding CV benefits, as Blacks fared better with canagliflozin and Asians with empagliflozin. Increases in lower extremity amputation and fracture incidence were observed with canagliflozin in CANVAS and this needs further substantiation, though these events were not systematically captured in the EMPA-REG study.
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spelling pubmed-56889862017-11-29 SGLT2 Inhibitors Through the Windows of EMPA-REG and CANVAS Trials: A Review Rastogi, Ashu Bhansali, Anil Diabetes Ther Review EMPA-REG OUTCOME and CANVAS trials were designed to study the cardiovascular safety of empagliflozin and canagliflozin, respectively. Both studies were sufficiently powered to study the non-inferiority for cardiovascular (CV) outcomes in patients with type 2 diabetes mellitus (DM) and showed superiority for major adverse cardiovascular events and composite renal outcomes independent of glycemic control. Further, all patients in EMPA-REG had prior CV events (secondary prevention), compared to CANVAS that also included subjects with no prior CV events, indicating the beneficial effects of canagliflozin in primary prevention of CV events as well. Moreover, there seems to be ethnic variations in response to sodium-glucose cotransporter 2 inhibitors (SGLT2i) regarding CV benefits, as Blacks fared better with canagliflozin and Asians with empagliflozin. Increases in lower extremity amputation and fracture incidence were observed with canagliflozin in CANVAS and this needs further substantiation, though these events were not systematically captured in the EMPA-REG study. Springer Healthcare 2017-10-26 2017-12 /pmc/articles/PMC5688986/ /pubmed/29076040 http://dx.doi.org/10.1007/s13300-017-0320-1 Text en © The Author(s) 2017 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Review
Rastogi, Ashu
Bhansali, Anil
SGLT2 Inhibitors Through the Windows of EMPA-REG and CANVAS Trials: A Review
title SGLT2 Inhibitors Through the Windows of EMPA-REG and CANVAS Trials: A Review
title_full SGLT2 Inhibitors Through the Windows of EMPA-REG and CANVAS Trials: A Review
title_fullStr SGLT2 Inhibitors Through the Windows of EMPA-REG and CANVAS Trials: A Review
title_full_unstemmed SGLT2 Inhibitors Through the Windows of EMPA-REG and CANVAS Trials: A Review
title_short SGLT2 Inhibitors Through the Windows of EMPA-REG and CANVAS Trials: A Review
title_sort sglt2 inhibitors through the windows of empa-reg and canvas trials: a review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5688986/
https://www.ncbi.nlm.nih.gov/pubmed/29076040
http://dx.doi.org/10.1007/s13300-017-0320-1
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