BMJ (Clinical research ed.)

Heart health outcomes linked to canagliflozin compared to other diabetes drugs in a large patient group

Updated

Abstract

The hazard ratio for heart failure admission to hospital associated with canagliflozin was 0.70 compared to DPP-4 inhibitors.

  • Canagliflozin may lower the risk of heart failure admissions compared to DPP-4 inhibitors, GLP-1 receptor agonists, and sulfonylureas.
  • The hazard ratios for heart failure admissions were 0.70 versus DPP-4i, 0.61 versus GLP-1RA, and 0.51 versus sulfonylurea.
  • Canagliflozin was associated with a similar risk for a composite cardiovascular endpoint compared to these treatment options.
  • The hazard ratio for the composite cardiovascular endpoint was 0.89 versus DPP-4i, 1.03 versus GLP-1RA, and 0.86 versus sulfonylurea.
  • Results were consistent across various patient subgroups and after adjusting for baseline hemoglobin A1c levels.

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Funding

Competing interests

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and have the following declarations. EP reports research grants from GSK and Boehringer-Ingelheim, not directly related to the topic of the submitted work. ABG reports grants from National Institutes of Health, American Diabetes Association, and Cleveland Clinic, other from National Institutes of Health, Diasome, Xoma, BAROnova, Caraco Pharmaceuticals, Amneal Pharmaceuticals, Lifescan, NovoNordisk, and Boston Heart Diagnostics, personal fees from Kowa, outside the submitted work. Work was performed during employment at Joslin Diabetes Center, now an employee of Novartis. SS is consultant to WHISCON LLC and to Aetion Inc, a software manufacturer of which he also owns equity. He is principal investigator of investigator-initiated grants to the Brigham and Women’s Hospital from Genentech, Bayer, Boehringer Ingelheim, US Food and Drug Administration, and Patient-Centered Outcomes Research Institute, not directly related to the topic of the submitted work. BME reports grants from Roche Diagnostics and Novartis Pharmaceuticals, consulting for Novartis Pharmaceuticals, Roche Diagnostics, Abbott Laboratories, US Food and Drug Administration, and UpToDate, outside the submitted work. BME serves as the co-chair of the American College of Cardiology's Task Force on Expert Clinical Decision Pathways Managing CV Disease Risk in Patients with Type 2 Diabetes. RJG reports grants from Pfizer, Novartis, and Kowa outside the submitted work. SCK reports grants from Pfizer Inc, AstraZeneca, Bristol-Myers Squibb, Merck, and Genentech, outside the submitted work.
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