1216-P: The Effects of Canagliflozin on Uric Acid and Gout in Patients with Type 2 Diabetes in the CANVAS Program

Abstract

Sodium glucose co-transporter 2 (SGLT2) inhibitors reduce serum uric acid levels. We investigated the effect of canagliflozin compared to placebo on gout in the CANagliflozin cardioVascular Assessment Study (CANVAS) Program. The CANVAS Program randomly assigned 10,142 participants with type 2 diabetes to canagliflozin or placebo. Adverse events and serious adverse events attributed to gout, hyperuricemia or hyperuricosuria were identified and the effects of canagliflozin compared to placebo were estimated by calculating the hazard ratio (HR) and 95% confidence interval (95% CI). Mean serum urate levels at baseline were 348.2 (standard deviation 94.3) µmol/L in the canagliflozin group and 349.8 (97.1) µmol/L in the placebo group. Serum urate levels were 23.2 µmol/L (95% CI: -25.6 to -20.9) lower in the canagliflozin versus placebo group at 6 to 13 weeks after randomization and on average were 23.3 µmol/L (95% CI: -25.4 to -21.3) lower during follow-up. There were 80 individuals who reported gout and 76 who reported hyperuricemia or hyperuricosuria during follow-up. The HR for gout was 0.64 (95% CI: 0.41 to 0.99) in those treated with canagliflozin compared to placebo. The corresponding HR for hyperuricemia or hyperuricosuria was 0.57 (95% CI: 0.36 to 0.90) and the HR for a gout, hyperuricemia or hyperuricosuria event was 0.62 (95% CI: 0.45 to 0.85). Canagliflozin reduced serum urate levels and the risk of adverse events attributed to gout. Disclosure J. Li: Employee; Self; George Institute for Global Health. S.V. Badve: None. Z. Zhou: None. R. Oh: Employee; Self; Janssen Research & Development. M. Lee: Employee; Self; Janssen Research & Development. V. Perkovic: Advisory Panel; Self; AbbVie Inc., Astellas Pharma Inc., AstraZeneca, Baxter, Bayer US, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Durect Corporation, Eli Lilly and Company, Gilead Sciences, Inc., GlaxoSmithKline plc., Janssen Research & Development, Merck & Co., Inc., Novartis Pharmaceuticals Corporation, Pfizer Inc., Pharmalink, Relypsa, Inc., Roche Pharma, Sanofi, Servier, Vitae. Research Support; Self; Australian National Health and Medical Research Council. Other Relationship; Self; AbbVie Inc., Boehringer Ingelheim Pharmaceuticals, Inc., GlaxoSmithKline plc., Janssen Research & Development, Pfizer Inc. 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. 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. 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. 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. 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. Funding Janssen Research & Development, LLC