# Canagliflozine en renale uitkomsten bij diabetes type 2 met nefropathie: NEJM CREDENCE

*geplaatst 2019-06-13 · Preventie · The New England journal of medicine · doi 10.1056/NEJMoa1811744 · https://hartvaat.nl/2019/06/13/canagliflozine-en-renale-uitkomsten-bij-diabetes-type-2-met-nefropathie-nejm-cre/*

Landmark NEJM CREDENCE-trial die aantoonde dat canagliflozine renale uitkomsten significant verbetert bij diabetische nefropathie. Eerste SGLT2-remmer specifiek voor nierziekte.

## English: Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy.

The CREDENCE trial demonstrated that canagliflozin significantly reduced the risk of kidney failure, cardiovascular events, and death in patients with type 2 diabetes and chronic kidney disease. As the first dedicated renal outcomes trial for an SGLT2 inhibitor, it established this drug class as a cornerstone of diabetic nephropathy treatment.

## Abstract (original, from the publication)

BACKGROUND: Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium-glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS: In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin-angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS: The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P = 0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P = 0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P = 0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS: In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years. (Funded by Janssen Research and Development; CREDENCE ClinicalTrials.gov number, NCT02065791.).

Auteurs: Vlado Perkovic, Meg J Jardine, Bruce Neal, Severine Bompoint, Hiddo J L Heerspink, David M Charytan, Robert Edwards, Rajiv Agarwal, George Bakris, Scott Bull, Christopher P Cannon, George Capuano, Pei-Ling Chu, Dick de Zeeuw, Tom Greene, Adeera Levin, Carol Pollock, David C Wheeler, Yshai Yavin, Hong Zhang, Bernard Zinman, Gary Meininger, Barry M Brenner, Kenneth W Mahaffey

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Bron: The New England journal of medicine, https://doi.org/10.1056/NEJMoa1811744. Bijgewerkt 2026-07-03T13:27:11Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.