Canagliflozin may Reduce Risk of Anemia in Diabetic Patients with CKD: Lancet

Researchers used the linear mixed-effects models to assess the effects of canagliflozin and matched placebo on haemoglobin and haematocrit. The major outcome assessed was a composite outcome of investigator-reported anaemia or treatment for anaemia, which was assessed using Kaplan-Meier analysis and Cox regression models. All analyses were done by intention to treat.

Key findings of the study were:

♦ At baseline, the researchers noted that the mean haemoglobin concentration was 132·0 g/L (SD 17·7).

♦ They also noted that about 36% of participants had anaemia, and less than 1% were on erythropoiesis-stimulating agents.

♦ During a median follow-up period of 2·6 years, they found a rise in the mean haemoglobin concentration (7·1 g/L) and haematocrit level 2·4% among canagliflozin group than in the placebo group.

♦ They observed that 573 of 4401 participants had either an investigator-reported anaemia event or the initiation of treatment for anaemia:

            • 358 (8%) of 4401 participants reported anaemia events,

            • 343 (8%) initiated iron preparations,

            • 141 (3%) received erythropoiesis-stimulating agents and

            • 114 (2%) received a blood transfusion.

♦ They noted that the risk of the composite outcome of anaemia events or the initiation of treatment for anaemia was lower in the canagliflozin group than the placebo group (hazard ratio 0·65)

♦ They also noted, compared with the placebo group, participants in the canagliflozin group also had lower risks of anaemia (0·58), initiation of iron preparations (0·64), and need for erythropoiesis-stimulating agents (0·65).

The authors concluded, "These data suggest that canagliflozin reduces the risk of anaemia-associated outcomes, including the need for erythropoiesis-stimulating agents, among patients with type 2 diabetes and chronic kidney disease."

For further information:

https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30300-4/fulltext