1203-P: Cause of Hospitalizations in Patients with Type 2 Diabetes Mellitus (T2DM) in the CANVAS Program

Abstract

T2DM patients have multiple comorbidities and frequent hospitalizations. SGLT2 inhibitors have demonstrated decreased hospitalization for heart failure vs. standard of care, but data on hospitalization for other causes are limited. The CANVAS Program randomly assigned 10,142 participants with T2DM and prior history (secondary prevention; n = 6656) or risk (primary prevention; n = 3486) for cardiovascular disease to canagliflozin (CANA) or placebo (mean follow-up, 188 week). All-cause hospitalization analyses were prespecified, but analyses of specific causes of hospitalization were not. Microvascular complications included eye, nerve, and kidney and macrovascular complications included cardiac and vascular. CANA reduced overall hospitalization (HR [95% CI]: 0.94 [0.88, 1.00]; secondary prevention: 0.91 [0.84, 0.99]; primary prevention: 1.01 [0.88, 1.15]). The most common reasons for hospitalization were infection, other, metabolism, cardiovascular, and musculoskeletal (Figure). CANA reduced hospitalization for macrovascular complications (overall: 7.98% vs. 10.63%, P <0.0001; secondary prevention: 9.25% vs. 12.66%, P <0.0001; primary prevention: 5.86% vs. 7.02%, P = 0.005), but not for microvascular complications (overall: 1.99% vs. 2.20%, P = NS). CANA reduced all-cause hospitalization overall and macrovascular hospitalization in both primary and secondary prevention participants. Disclosure K.W. Mahaffey: Consultant; Self; Abbott, Ablynx, Baim Institute, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Cardiometabolic Health Congress, Elsevier, GlaxoSmithKline plc., Medergy, Medscape, Mitsubishi Tanabe Pharma Corporation, MyoKardia, Inc., Novo Nordisk Inc., Ocleuve, Portola Pharmaceuticals, Inc., Radiometer America, Springer Publishing, Theravance, UCSF. Research Support; Self; Afferent, Amgen Inc., Apple, Cardiva Medical, Inc, Daiichi, Ferring Pharmaceuticals, Google, Luitpold Pharmaceuticals, Inc., Medtronic, Sanofi, St.Jude, Tenax. Stock/Shareholder; Self; BioPrint Fitness. Other Relationship; Self; AstraZeneca, Johnson & Johnson, Merck & Co., Inc., National Institutes of Health, Novartis Pharmaceuticals Corporation. J. Ianus: Employee; Self; Janssen Scientific Affairs, LLC. C.V. Damaraju: Employee; Self; Janssen Scientific Affairs, LLC. B. Neal: Advisory Panel; Self; Janssen Research & Development, Novartis Pharmaceuticals Corporation, Pfizer Inc., Roche Pharma, Servier. Research Support; Self; Abbott, Australian National Health and Medical Research Council, Janssen Research & Development, Merck & Co., Inc., Roche Pharma, Servier. D. de Zeeuw: Advisory Panel; Self; Bayer US, Boehringer Ingelheim Pharmaceuticals, Inc., Fresenius Medical Care, Mitsubishi Tanabe Pharma Corporation, Mundipharma. Other Relationship; Self; AbbVie Inc., Bayer US, Janssen Research & Development. G. Fulcher: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Research & Development, Merck Sharp & Dohme Corp., Novo Nordisk Inc. Consultant; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Research & Development, Merck Sharp & Dohme Corp., Novo Nordisk Inc. Research Support; Self; Novo Nordisk Inc. M. Pfeifer: Employee; Self; Janssen Scientific Affairs, LLC. D.R. Matthews: Advisory Panel; Self; Janssen Research & Development, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Sanofi, Servier. Consultant; Self; Janssen Research & Development, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Servier. Research Support; Self; Janssen Research & Development. Speaker's Bureau; Self; Aché Laboratories, Janssen Research & Development, Mitsubishi Tanabe Pharma Corporation, Novartis Pharmaceuticals Corporation, Novo Nordisk Inc., Sanofi, Servier. Funding Janssen Research & Development, LLC