Canagliflozin and Cardiovascular Outcomes in Type 2 Diabetes

Abstract

SGLT2 inhibitors have risen to prominence in recent years as Type 2 diabetes mellitus medications with favorable effects on cardiovascular (CV) and renal outcomes. Canagliflozin is a US FDA-approved SGLT2 inhibitor that has demonstrated CV and renal outcome benefits in large scale placebo-controlled randomized trials of patients with Type 2 diabetes mellitus and elevated CV risk. Canagliflozin use may also be associated with serious and nonserious adverse effects requiring ongoing monitoring in patients initiated on this medication. This paper provides a detailed overview of canagliflozin including its pharmacologic profile, clinical efficacy and safety data, with discussion of both clinical trial results, as well as real-world evidence.

Keywords:

• canagliflozin
• cardiovascular disease
• chronic kidney disease
• nephropathy
• SGLT2
• sodium glucose cotransporter 2 inhibitors
• Type 2 diabetes

Author contributions

A Sarraju (conceptualization, manuscript writing, critical revisions and manuscript editing); G Spencer-Bonilla (manuscript writing, critical revisions and manuscript editing); F Rodriguez (conceptualization, critical revisions and manuscript editing); KW Mahaffey (conceptualization, critical revisions and manuscript editing, supervision).

Financial & competing interests disclosure

KW Mahaffey has received research support from Afferent, Amgen, Apple, Inc, AstraZeneca, Cardiva Medical, Inc, Daiichi Sankyo, Ferring, Google (Verily), Johnson & Johnson, Luitpold, Medtronic, Merck, National Institutes of Health (NIH), Novartis, Sanofi, St. Jude, and Tenax; and has served as a consultant (speaker fees for continuing medical education events only) for Abbott, Ablynx, AstraZeneca, Baim Institute, Boehringer Ingelheim, Bristol-Myers Squibb, Elsevier, GlaxoSmithKline, Johnson & Johnson, MedErgy, Medscape, Mitsubishi, MyoKardia, NIH, Novartis, Novo Nordisk, Portola, Radiometer, Regeneron, Springer Publishing, and the University of California, San Francisco. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.