Renoprotection with Canagliflozin

The sodium–glucose cotransporter 2 inhibitor canagliflozin (Invokana) is FDA-approved to lower cardiovascular (CV) risk in patients with type 2 diabetes and established CV disease. Now, industry-supported researchers have examined the drug's effect on renal outcomes in 4400 patients with type 2 diabetes. Enrollment criteria included estimated glomerular filtration rate between 30 and 90 mL/minute/1.73 m² (mean, 56) and urinary albumin-to-creatinine ratio between 300 and 5000. Mean age was 63, and mean glycosylated hemoglobin (HbA_1c) level was 8.3%; 66% of patients were taking insulin, and 58% were taking metformin.

Patients were randomized to receive either canagliflozin or placebo. At median follow-up of 2.6 years, the primary composite out…