942-P: Renal Outcomes Associated with Canagliflozin 100 mg and Subsequent Intensification to Canagliflozin 300 mg in Patients with Type 2 Diabetes Mellitus in the INTENSIFY Study
Authors: GORGOJO-MARTINEZ JUAN J. , ALMODÓVAR-RUIZ FRANCISCA , BRITO MIGUEL , ANTÓN-BRAVO TERESA , GALDON-SANZPASTOR ALBA , FERREIRA-OCAMPO PABLO J. , CÁRDENAS-SALAS JERSY J. 
Published: June 2024

Objective: This analysis, based on the multicentric observational study INTENSIFY, aimed to evaluate renal outcomes associated with canagliflozin 100 mg/d (CANA100), as add-on to the background antihyperglycemic therapy, and later intensification by switching to canagliflozin 300 mg/d (CANA300) in patients with T2DM and estimated glomerular filtration rate (eGFR) &gt;60 ml/min/1.73m2.

Methods: A total of 317 patients (59.6% men, mean age 60.9 y, A1c 8.4%, BMI 33.1 kg/m2, systolic BP (SBP) 138.9 mmHg, eGFR 87.9 ml/min/1.73 m2, urine albumin-to-creatinine ratio (UACR) &gt;30 mg/g 28.6%) were included, with a median follow-up of 38.8 months. Primary outcomes were changes in UACR and eGFR over the follow-up.

Results: Treatment with CANA100 and subsequent switch to CANA300 led to significant reductions in UACR (mean change -44.8 mg/g, p 0.008). The percentage of patients with UACR 30-300 mg/g significantly decreased from 22.2% to 16.0% and the percentage of those with UACR &gt;300 mg/g lowered from 6.4% to 2.0% (p 0.005). There was a significant decrease in eGFR (-4.0%, p &lt; 0.0001) over the follow-up. The eGFR slope in the maintenance phase (after the first 6 months) was -0.21 ml/min/1.73 m2 per year. Intensification to CANA300 induced an additional reduction in UACR without a significant drop in eGFR. Patients achieved a statistically significant overall reduction in A1c (-1.30%), weight (-5.8 kg), SBP (-9.6 mmHg), and DBP (-4.7 mmHg), at the end of the follow-up, all p &lt; 0.0001. There was a numerical reduction in the use of diuretics; no significant changes in ACEs/ARBs therapy were observed. Only 2 patients (0.6%) experienced episodes of volume depletion.

Conclusion: Sequential treatment with CANA100 and later switch to CANA300 was associated with a significant improvement in UACR, likely due to multifactorial effects of the drug.

Disclosure

J.J. Gorgojo-Martinez: Research Support; Mundipharma. Speaker's Bureau; Mundipharma, AstraZeneca, Lilly Diabetes, Novo Nordisk. Research Support; Novo Nordisk. Advisory Panel; Novo Nordisk. Speaker's Bureau; Boehringer-Ingelheim. Advisory Panel; Boehringer-Ingelheim. Speaker's Bureau; Amarin Corporation. F. Almodóvar-Ruiz: Research Support; Mundipharma. M. Brito: Speaker's Bureau; Abbott, Almirall, S.A., AstraZeneca, Bayer Inc., Daiichi Sankyo, Dexcom, Inc., Eli Lilly and Company, Merck Sharp & Dohme Corp. Research Support; Mundipharma. Speaker's Bureau; Novartis Pharmaceuticals Corporation, Novo Nordisk, Mundipharma. Advisory Panel; Sanofi. Research Support; Novartis Pharmaceuticals Corporation. Speaker's Bureau; Boehringer-Ingelheim, Amgen Inc. T. Antón-Bravo: Speaker's Bureau; Novo Nordisk, Daiichi Sankyo, Lilly Diabetes, Boehringer-Ingelheim. A. Galdon-SanzPastor: Speaker's Bureau; Amgen Inc., Lilly Diabetes, A. Menarini Diagnostics, Novo Nordisk. P.J. Ferreira-Ocampo: Research Support; Danone Nutricia, Vegenat Healthcare, Fresenius Kabi, Grupo Menarini. J.J. Cárdenas-Salas: Speaker's Bureau; Novo Nordisk. Other Relationship; Novo Nordisk. Research Support; Mundipharma. Speaker's Bureau; Viatris Inc. Other Relationship; Eli Lilly and Company. Speaker's Bureau; Sanofi. Other Relationship; Sanofi, Menarini.

Funding

Mundipharma Pharmaceuticals (Number21/157).