Consistent Outcomes with Canagliflozin (CANA) in Patients with Type 2 Diabetes across Geographic Regions—Results from the CANagliflozin CardioVascular Assessment Study (CANVAS) Program

Abstract

In the global CANVAS Program (n = 10,142), CANA, an SGLT2 inhibitor, demonstrated risk reductions in cardiovascular (CV) and renal outcomes in patients with type 2 diabetes and established CV disease or ≥2 CV risk factors. A pre-specified analysis evaluated outcomes in patients from different geographic regions. Overall, 2,430 (24.0%) were from North America, 1,021 (10.1%) were from Central/South America, 3,609 (35.6%) were from Europe, and 3,082 (30.4%) were from the rest of the world. The primary outcome was comprised of CV death, nonfatal myocardial infarction, or nonfatal stroke; other CV and renal outcomes were also analyzed. The primary outcome occurred in 2.80, 2.99, 3.07, and 2.69 patients per 100 patient-years (unadjusted) in North America, Central/South America, Europe, and the rest of the world, respectively. The effects of CANA on the primary outcome were consistent between patients from different geographic regions (interaction P = 0.89) and with the total population (HR [95% CI]: 0.86 [0.75, 0.97]; Figure). Similar effects between subgroups were observed in the individual components of the primary outcome, all-cause mortality, hospitalization for heart failure, and progression of albuminuria. The risk reduction observed with CANA on CV and renal outcomes was consistent across geographic regions. Disclosure C.H. Wysham: Advisory Panel; Self; Abbott, AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Sanofi. Consultant; Self; AstraZeneca, Janssen Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Insulet Corporation, Novo Nordisk Inc., Sanofi. A. Bhattacharyya: None. M. Tsoukas: Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc., Novo Nordisk Inc.. Advisory Panel; Self; Sanofi. Speaker's Bureau; Self; Eli Lilly and Company. E. Martinez-Abundis: Advisory Panel; Self; AstraZeneca. Speaker's Bureau; Spouse/Partner; AstraZeneca. Advisory Panel; Spouse/Partner; AstraZeneca. Speaker's Bureau; Spouse/Partner; AstraZeneca. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc.. Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company. Advisory Panel; Spouse/Partner; Eli Lilly and Company. Speaker's Bureau; Spouse/Partner; Eli Lilly and Company. Advisory Panel; Self; Janssen Pharmaceuticals, Inc.. Research Support; Self; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Janssen Pharmaceuticals, Inc.. Advisory Panel; Spouse/Partner; Janssen Pharmaceuticals, Inc.. Research Support; Spouse/Partner; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Spouse/Partner; Janssen Pharmaceuticals, Inc.. Speaker's Bureau; Self; Novartis Pharmaceuticals Corporation, Sanofi. Speaker's Bureau; Spouse/Partner; Sanofi. Advisory Panel; Self; Takeda Development Center Americas, Inc.. Speaker's Bureau; Self; Takeda Development Center Americas, Inc.. Advisory Panel; Spouse/Partner; Takeda Development Center Americas, Inc.. Speaker's Bureau; Spouse/Partner; Takeda Development Center Americas, Inc.. Research Support; Self; Merck Sharp & Dohme Corp.. Research Support; Spouse/Partner; Merck Sharp & Dohme Corp., Pfizer Inc.. Advisory Panel; Self; Laboratorios Silanes. Speaker's Bureau; Self; Laboratorios Silanes. Advisory Panel; Spouse/Partner; Laboratorios Silanes. Research Support; Spouse/Partner; Laboratorios Silanes. Speaker's Bureau; Spouse/Partner; Laboratorios Silanes. A. Slee: Other Relationship; Self; Janssen Scientific Affairs, LLC. W. Shaw: Employee; Self; Janssen Research & Development. K.W. Mahaffey: Research Support; Self; Afferent, Amgen, AstraZeneca, Daiichi, Ferring, Google (Verily), Janssen, Medtronic, Merck, Novartis, Sanofi, and St. Jude. Consultant; Self; Ablynx, AstraZeneca, BAROnova, Bio2 Medical, Boehringer Ingelheim, Bristol-Myers Squibb, Cardiometabolic Health Congress, Cubist, Eli Lilly, Elsevier, Epson, GlaxoSmithKline, Janssen, Merck, Mt. Sinai, Radiometer, Springer Publishing, The Medicines Company, Theravance, Vindico, and WebMD. Stock/Shareholder; Self; BioPrint Fitness. D. de Zeeuw: Other Relationship; Self; AbbVie Inc., Astellas Pharma US, Inc., Eli Lilly and Company, Fresenius SE & Co. KGaA, Janssen Scientific Affairs, LLC., Boehringer Ingelheim GmbH, Bayer AG, Mitsubishi Tanabe Pharma Corporation.