Australia: Patients with chronic kidney disease (CKD) and type 2 diabetes who received SGLT2 inhibitor canagliflozin had a lower risk of anemia, according to a recent study in the journal Lancet Diabetes & Endocrinology. Canagliflozin also reduced the need for erythropoiesis-stimulating agents.
Sodium-glucose co-transporter 2 (SGLT2) inhibitors might enhance process of RBC production (erythropoiesis) and increase red blood cell mass. Megumi Oshima, The George Institute for Global Health, UNSW Sydney, Sydney, NSW, Australia, and colleagues assessed the long-term effects of canagliflozin on anaemia-related outcomes.
The primary outcome of this post-hoc analysis was a composite outcome of investigator-reported anaemia or treatment for anaemia, which was assessed using Kaplan-Meier analysis and Cox regression models.
At baseline, mean haemoglobin concentration was 132·0 g/L (SD 17·7), 1599 (36%) of 4401 participants had anaemia (defined as haemoglobin <130 g/L in men or <120 g/L in women), and 33 (<1%) of 4401 participants used erythropoiesis-stimulating agents.
Key findings of the study include:
- During a median follow-up period of 2·6 years, mean haemoglobin concentration was 7·1 g/L higher and haematocrit was 2·4% higher in the canagliflozin group than the placebo group.
- 573 of 4401 participants had either an investigator-reported anaemia event or initiation of treatment for anaemia: 358 (8%) of 4401 participants reported anaemia events, 343 (8%) initiated iron preparations, 141 (3%) initiated erythropoiesis-stimulating agents, and 114 (2%) received blood transfusion.
- The risk of the composite outcome of anaemia events or initiation of treatment for anaemia was lower in the canagliflozin group than the placebo group (hazard ratio 0·65).
- Compared with the placebo group, participants in the canagliflozin group also had lower risks of anaemia events alone (0·58), initiation of iron preparations (0·64), and need for erythropoiesis-stimulating agents (0·65).
"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," concluded the authors.
"Effects of canagliflozin on anaemia in patients with type 2 diabetes and chronic kidney disease: a post-hoc analysis from the CREDENCE trial," is published in the journal Lancet Diabetes & Endocrinology.
DOI: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(20)30300-4/fulltext
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