The CREDENCE trial evaluated canagliflozin's effects on renal outcomes in patients with Type 2 diabetes and albuminuric chronic kidney disease
4,401 patients were randomized across 690 sites in 34 countries, with a median follow-up of 2.62 years
Key Findings
Canagliflozin resulted in a 30% lower relative risk of the primary composite outcome (end-stage kidney disease, doubling of serum creatinine, or renal/cardiovascular death)
The treatment group showed lower risks of end-stage kidney disease, cardiovascular events, and hospitalization for heart failure
Safety Profile
Overall rates of adverse events were similar between canagliflozin and placebo groups
No significant difference in lower-limb amputation risk was observed between the groups
Conclusions
Canagliflozin demonstrated renoprotective effects in patients with Type 2 diabetes and kidney disease, independent of its glucose-lowering effects
The study's results support the use of canagliflozin for renoprotection in patients with Type 2 diabetes and chronic kidney disease
🎯 BACKGROUND
The prevalence of Type 2 diabetes has exhibited a marked increase over recent decades, consequently leading to a notable rise in end-stage kidney disease on a global scale.
As of present, approximately 3 million individuals worldwide are undergoing treatment for kidney failure, with projections indicating this figure may surpass 5 million by the year 2035.
The renin-angiotensin system blockade remains the sole approved treatment for renoprotection in patients with Type 2 diabetes, having demonstrated efficacy initially 18 years ago.
SGLT2 inhibitors, originally developed to reduce blood glucose levels in Type 2 diabetes patients, have demonstrated potential in mitigating cardiovascular events during safety trials.
Secondary analyses of these trials have indicated possible renal benefits from SGLT2 inhibition; however, uncertainty persisted due to insufficient data on end-stage kidney disease outcomes.
AIM of Credence 2020
The CREDENCE trial was specifically designed to evaluate the effects of canagliflozin (an SGLT2 inhibitor) on renal outcomes in patients diagnosed with Type 2 diabetes and albuminuric chronic kidney disease.
Ethical Oversight: The trial protocol underwent review by relevant regulatory authorities and ethics committees for each trial site.
Sponsorship and Collaboration: Janssen Research and Development sponsored the trial, collaborating with an academic-led steering committee and George Clinical, an academic research organization. IQVIA, a contract research organization, handled operational implementation.