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Effects of canagliflozin on initiation of insulin and other antihyperglycaemic agents in the CANVAS Program

This study compared initiation of insulin and other antihyperglycaemic agents (AHAs) with canagliflozin versus placebo for participants with type 2 diabetes and a history/high risk of cardiovascular disease in the CANagliflozin cardioVascular Assessment Study (CANVAS) Program. After 1 year, fewer pa...

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Autores principales: Matthews, David R., Wysham, Carol, Davies, Melanie, Slee, April, Alba, Maria, Lee, Mary, Perkovic, Vlado, Mahaffey, Kenneth W., Neal, Bruce
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7693248/
https://www.ncbi.nlm.nih.gov/pubmed/32691499
http://dx.doi.org/10.1111/dom.14143
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author Matthews, David R.
Wysham, Carol
Davies, Melanie
Slee, April
Alba, Maria
Lee, Mary
Perkovic, Vlado
Mahaffey, Kenneth W.
Neal, Bruce
author_facet Matthews, David R.
Wysham, Carol
Davies, Melanie
Slee, April
Alba, Maria
Lee, Mary
Perkovic, Vlado
Mahaffey, Kenneth W.
Neal, Bruce
author_sort Matthews, David R.
collection PubMed
description This study compared initiation of insulin and other antihyperglycaemic agents (AHAs) with canagliflozin versus placebo for participants with type 2 diabetes and a history/high risk of cardiovascular disease in the CANagliflozin cardioVascular Assessment Study (CANVAS) Program. After 1 year, fewer participants treated with canagliflozin versus placebo initiated any AHA (7% vs. 16%), insulin (3% vs. 9%) or any non‐insulin AHA (5% vs. 12%) (P < .001 for all); overall AHA initiation rates increased over time but were consistently lower with canagliflozin compared with placebo. During the study, the likelihood of initiating insulin was 2.7 times lower for participants treated with canagliflozin compared with placebo (hazard ratio, 0.37; 95% CI: 0.31, 0.43; P < .001). The time difference between 10% of patients in the canagliflozin and placebo groups being initiated on insulin from the beginning of the trial was about 2 years. Time to initiation of other AHAs, including metformin, dipeptidyl peptidase‐4 inhibitors, glucagon‐like peptide‐1 receptor agonists and sulphonylureas, was also delayed for canagliflozin versus placebo (P < .001 for each). Compared with placebo, canagliflozin delayed the need for initiation of other AHAs and delayed time to insulin therapy, an outcome that is important to many people with diabetes.
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spelling pubmed-76932482020-12-11 Effects of canagliflozin on initiation of insulin and other antihyperglycaemic agents in the CANVAS Program Matthews, David R. Wysham, Carol Davies, Melanie Slee, April Alba, Maria Lee, Mary Perkovic, Vlado Mahaffey, Kenneth W. Neal, Bruce Diabetes Obes Metab Brief Reports This study compared initiation of insulin and other antihyperglycaemic agents (AHAs) with canagliflozin versus placebo for participants with type 2 diabetes and a history/high risk of cardiovascular disease in the CANagliflozin cardioVascular Assessment Study (CANVAS) Program. After 1 year, fewer participants treated with canagliflozin versus placebo initiated any AHA (7% vs. 16%), insulin (3% vs. 9%) or any non‐insulin AHA (5% vs. 12%) (P < .001 for all); overall AHA initiation rates increased over time but were consistently lower with canagliflozin compared with placebo. During the study, the likelihood of initiating insulin was 2.7 times lower for participants treated with canagliflozin compared with placebo (hazard ratio, 0.37; 95% CI: 0.31, 0.43; P < .001). The time difference between 10% of patients in the canagliflozin and placebo groups being initiated on insulin from the beginning of the trial was about 2 years. Time to initiation of other AHAs, including metformin, dipeptidyl peptidase‐4 inhibitors, glucagon‐like peptide‐1 receptor agonists and sulphonylureas, was also delayed for canagliflozin versus placebo (P < .001 for each). Compared with placebo, canagliflozin delayed the need for initiation of other AHAs and delayed time to insulin therapy, an outcome that is important to many people with diabetes. Blackwell Publishing Ltd 2020-08-24 2020-11 /pmc/articles/PMC7693248/ /pubmed/32691499 http://dx.doi.org/10.1111/dom.14143 Text en © 2020 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Brief Reports
Matthews, David R.
Wysham, Carol
Davies, Melanie
Slee, April
Alba, Maria
Lee, Mary
Perkovic, Vlado
Mahaffey, Kenneth W.
Neal, Bruce
Effects of canagliflozin on initiation of insulin and other antihyperglycaemic agents in the CANVAS Program
title Effects of canagliflozin on initiation of insulin and other antihyperglycaemic agents in the CANVAS Program
title_full Effects of canagliflozin on initiation of insulin and other antihyperglycaemic agents in the CANVAS Program
title_fullStr Effects of canagliflozin on initiation of insulin and other antihyperglycaemic agents in the CANVAS Program
title_full_unstemmed Effects of canagliflozin on initiation of insulin and other antihyperglycaemic agents in the CANVAS Program
title_short Effects of canagliflozin on initiation of insulin and other antihyperglycaemic agents in the CANVAS Program
title_sort effects of canagliflozin on initiation of insulin and other antihyperglycaemic agents in the canvas program
topic Brief Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7693248/
https://www.ncbi.nlm.nih.gov/pubmed/32691499
http://dx.doi.org/10.1111/dom.14143
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