Cardiovascular outcomes and mortality after initiation of canagliflozin: Analyses from the EASEL Study.
major adverse cardiovascular event
sodium glucose co‐transporter 2 inhibitor
type 2 diabetes mellitus
Journal
Endocrinology, diabetes & metabolism
ISSN: 2398-9238
Titre abrégé: Endocrinol Diabetes Metab
Pays: England
ID NLM: 101732442
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
05
08
2019
accepted:
15
09
2019
entrez:
11
1
2020
pubmed:
11
1
2020
medline:
11
1
2020
Statut:
epublish
Résumé
In the EASEL study of patients with type 2 diabetes and high cardiovascular risk, initiation of sodium glucose co-transporter 2 inhibitors (SGLT2i) was associated with lower risk of cardiovascular events and mortality and higher risk of below-knee lower extremity (BKLE) amputation versus non-SGLT2i therapies. This analysis further examined risk of cardiovascular events, cardiovascular and noncardiovascular death and BKLE amputation with the SGLT2i canagliflozin versus non-SGLT2i. New user cohorts were constructed from Department of Defense Military Health System patients initiating canagliflozin or non-SGLT2i (4/1/2013-12/31/2016). Propensity score matching (1:1) controlled for imbalances in baseline covariates. Incidence rates, hazard ratios and 95% confidence intervals for time to first composite outcome of all-cause mortality (ACM) and hospitalization for heart failure (HHF), composite major adverse cardiovascular events (MACE) and individual components were evaluated using conditional Cox models. The National Death Index was used to differentiate cardiovascular from noncardiovascular death. The exploratory safety end-point was BKLE amputation. After propensity matching, 15 394 patients with well-balanced baseline covariates were followed for a median of 2.03 years (intent-to-treat). Canagliflozin showed significant benefit for ACM and HHF ( In this high cardiovascular risk cohort studied in routine clinical practice, canagliflozin was associated with lower risk of cardiovascular events, cardiovascular death and all-cause mortality with no significant increase in BKLE amputation risk versus non-SGLT2i.
Identifiants
pubmed: 31922023
doi: 10.1002/edm2.96
pii: EDM296
pmc: PMC6947703
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e00096Informations de copyright
© 2019 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.
Déclaration de conflit d'intérêts
JAU has received consulting fees from Amgen, Boehringer Ingelheim, Janssen Research & Development, LLC, Merck, Novartis and Sanofi Pasteur; speaking honoraria from Boehringer Ingelheim and Janssen; and research grant support from AstraZeneca and Novartis. ZY, PR and NR are full‐time employees of Janssen Research & Development, LLC. TR and NMS are full‐time employees of Health ResearchTx, LLC, which has a business relationship with Janssen. MG reports no conflicts of interest.
Références
Circulation. 2018 Jul 31;138(5):458-468
pubmed: 29526832
PLoS One. 2015 Aug 20;10(8):e0135834
pubmed: 26292280
Circ Cardiovasc Qual Outcomes. 2015 Mar;8(2):204-12
pubmed: 25648464
Open Med. 2007 Apr 14;1(1):e18-26
pubmed: 20101286
Circulation. 2018 Jan 23;137(4):323-334
pubmed: 29133604
Eur Heart J. 2018 Feb 1;39(5):363-370
pubmed: 29020355
Diabetes Care. 2002 Mar;25(3):512-6
pubmed: 11874939
Nephrol Dial Transplant. 2012 May;27(5):1826-31
pubmed: 22015442
Pharmacoepidemiol Drug Saf. 2012 Jan;21 Suppl 1:154-62
pubmed: 22262602
N Engl J Med. 2019 Jan 24;380(4):347-357
pubmed: 30415602
N Engl J Med. 2016 Mar 24;374(12):1145-54
pubmed: 27007958
Circulation. 2017 Jul 18;136(3):249-259
pubmed: 28522450
Stroke. 2005 Aug;36(8):1776-81
pubmed: 16020772
PLoS One. 2014 Aug 15;9(8):e104519
pubmed: 25126761
J Am Coll Cardiol. 2018 Jun 12;71(23):2628-2639
pubmed: 29540325
Endocrinol Diabetes Metab. 2019 Oct 15;3(1):e00096
pubmed: 31922023
Circulation. 2017 Oct 24;136(17):1643-1658
pubmed: 29061576
JAMA. 2014 Aug 27;312(8):841-3
pubmed: 25157729
Circulation. 2016 Dec 13;134(24):1915-1917
pubmed: 27956401
Circulation. 2018 Apr 3;137(14):1432-1434
pubmed: 29610125
Am Heart J. 2002 Aug;144(2):290-6
pubmed: 12177647
Diabetes Care. 2018 Jan;41(1):6-10
pubmed: 29263192
BMJ. 2018 Feb 6;360:k119
pubmed: 29437648
N Engl J Med. 2017 Aug 17;377(7):644-657
pubmed: 28605608
Diabetes Obes Metab. 2018 Dec;20(12):2792-2799
pubmed: 29971914
Diabetes Obes Metab. 2018 Nov;20(11):2585-2597
pubmed: 29938883
N Engl J Med. 2015 Nov 26;373(22):2117-28
pubmed: 26378978
Acad Emerg Med. 2013 Feb;20(2):193-9
pubmed: 23406079
PLoS One. 2019 Jul 8;14(7):e0218919
pubmed: 31283787
Circulation. 2018 Apr 3;137(14):1450-1459
pubmed: 29133607
BMJ. 2018 Nov 14;363:k4365
pubmed: 30429124
Lancet Diabetes Endocrinol. 2015 May;3(5):356-66
pubmed: 25791290
Med Care. 2005 Feb;43(2):182-8
pubmed: 15655432
Pharmacoepidemiol Drug Saf. 2012 Jan;21 Suppl 1:141-7
pubmed: 22262600
Diabetes Obes Metab. 2018 Mar;20(3):582-589
pubmed: 28898514
PLoS One. 2014 Mar 28;9(3):e92286
pubmed: 24682186
Clin Pharmacokinet. 2015 Jul;54(7):691-708
pubmed: 25805666
Trends Cardiovasc Med. 2017 Apr;27(3):194-202
pubmed: 28291655