Type 2 drug canagliflozin shown to lower heart failure risk
Adults with type 2 diabetes beginning treatment with canagliflozin may have a lower risk for hospital admissions for heart failure, acute myocardial infarction, ischemic stroke or haemorrhage stroke, according to a study.
US researchers compared them with those beginning treatment with DPP-IV inhibitors, GLP-1 receptor agonists or sulfonylureas.
Professor Elisabetta Patorno, assistant professor of medicine at Harvard Medical School and associate epidemiologist in the division of pharmacoepidemiology and pharmacoeconomics at Brigham and Women’s Hospital, studied data from the Optim Clinformatics datamart.
They sought out adults with type 2 diabetes who initiated the SGLT2 inhibitor canagliflozin (Invokana, Janssen), a DPP-IV inhibitor, a GLP-1 receptor agonist or a sulfonylurea between April 2013 and September 2015. Researchers sought to determine the effects of each medication on hospital admission for heart failure and on a cardiovascular endpoint that included hospital admission for acute MI, ischemic stroke or haemorrhagic stroke.
Participants were divided into three propensity score-matched cohorts. Cohort one consisted of 17,667 pairs of people who initiated canagliflozin (mean age, 56.5 years; 44.9 per cent women) or a DPP-IV inhibitor (mean age, 56.5 years; 45 per cent women). Cohort two consisted of 20,539 pairs of people who initiated canagliflozin (mean age, 56.8 years; 47.3 per cent women) or a GLP-1 receptor agonist (mean age, 56.7 years; 47.2 per cent women). Cohort three consisted of 17,354 pairs of people who initiated canagliflozin (mean age, 55.9 years; 45 per cent women) or a sulfonylurea (mean age, 55.8 years; 45.2 per cent women). Follow-up was a mean 0.6 years.
The number of heart failure events was lower among all participants initiating canagliflozin compared with a DPP-IV inhibitor (canagliflozin, 91 events vs. DPP-IV inhibitor, 124 events; HR = 0.7; 95 per cent CI, 0.54-0.92), a GLP-1 receptor agonist (canagliflozin, 94 events vs. GLP-1 receptor agonist, 148 events; HR = 0.61; 95 per cent CI, 0.47-0.78) and a sulfonylurea (canagliflozin, 77 events vs. sulfonylurea, 154 events; HR = 0.51; 95 per cent CI, 0.38-0.67).
The number of the composite CV endpoint events was lower in participants initiating canagliflozin compared with a DPP-IV inhibitor (101 events vs. 108 events; HR = 0.89; 95 per cent CI, 0.68-1.17) and a sulfonylurea (93 events vs. 110 events; HR = 0.86; 95 per cent CI, 0.65-1.13); the event rate was higher in the canagliflozin group compared with the GLP-1 receptor agonist group (11 events vs. 102 events; HR = 1.03; 95 per cent CI, 0.79-1.35). Findings remained consistent after adjustment for baseline HbA1c and presence of CVD at baseline.
To read the study, click here.