133-LB: Canagliflozin Improves Cardiovascular and Renal Outcomes across Broad Geographic Regions: Results from CREDENCE

Background: Diabetes is the most common cause of kidney disease in people requiring renal replacement therapy (RRT). RRT is projected to dramatically increase globally, with the greatest increase in Asia. CREDENCE showed canagliflozin reduces kidney and cardiovascular (CV) events in individuals with type 2 diabetes (T2DM) and chronic kidney disease (CKD). Methods: We explored canagliflozin efficacy across geographic regions. A Cox proportional-hazards model was used to analyze the primary outcome (composite of end-stage kidney disease [dialysis, transplantation, or a sustained eGFR of Results: A total of 4401 participants were enrolled across North America (n=1182, 27%), Central and South America (n=941, 21%), Eastern Europe (n=947, 21%), Western Europe (n=421, 10%), Asia (n=749, 17%), and Other (n=161, 4%). Placebo event rates ranged widely, with 32 and 77 events/1000 patient-years in Western Europe and Asia, respectively. Canagliflozin consistently reduced the risk of the primary outcome in all geographic regions (see Figure, previously reported data on race also included). Conclusions: Event rates varied two-fold across regions and needs further study. Canagliflozin reduces the risk of kidney and CV events in all geographic regions. Disclosure K. Cardoza: None. B. Zinman: Advisory Panel; Self; Abbott Diabetes, Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company, Novo Nordisk, Sanofi. M. J. Jardine: Advisory Panel; Self; AstraZeneca, Bayer Inc., Boehringer Ingelheim International GmbH, Chinook, CSL Behring, Janssen Pharmaceuticals, Inc., Vifor Pharma Management Ltd., Research Support; Self; Amgen Inc., Dimerix, Eli Lilly and Company, Merck & Co., Inc., Speaker’s Bureau; Self; Amgen Inc. C. Arnott: None. A. Levin: Advisory Panel; Self; AstraZeneca, Johnson & Johnson, Research Support; Self; Boehringer Ingelheim International GmbH. K. W. Mahaffey: Consultant; Self; Abbott, Amgen Inc., Anthos, AstraZeneca, Baim Institute for Clinical Research, Bayer Healthcare Pharmaceuticals Inc., Boehringer Ingelheim Pharmaceuticals, Inc., CSL Behring, Elsevier, Inova, Intermountain Health, Johnson & Johnson, Medscape, Mount Sinai, Mundipharma International, MyoKardia, National Institutes of Health, Novartis Pharmaceuticals Corporation, Novo Nordisk, Otsuka America Pharmaceutical, Inc., Portola Pharmaceuticals, Inc., Regeneron Pharmaceuticals Inc., SmartMedics, Theravance Biopharma, Research Support; Self; Afferent, AHA, Amgen Inc., Apple, AstraZeneca, Bayer Healthcare Pharmaceuticals Inc., Cardiva Medical, Inc, Eidos, Ferring Pharmaceuticals Inc., Gilead Sciences, Inc., Google, Johnson & Johnson, Luitpold Pharmaceuticals, Inc., Medtronic, Merck & Co., Inc., National Institutes of Health, Novartis Pharmaceuticals Corporation, Sanifit, Sanofi, St. Jude Medical. A. Kang: None. B. Smyth: None. T. Yi: None. G. Di tanna: Consultant; Self; Amgen Inc. C. A. Pollock: None. D. De zeeuw: Consultant; Self; Boehringer Ingelheim International GmbH, Fresenius Medical Care, Retrophin, Inc., Other Relationship; Self; Bayer Healthcare Pharmaceuticals Inc. D. C. Wheeler: Advisory Panel; Self; Merck Sharp & Dohme Corp., Consultant; Self; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, GlaxoSmithKline plc., Janssen Global Services, LLC., Mundipharma International, Tricida, Inc., Speaker’s Bureau; Self; Amgen Astellas BioPharma, Astellas Pharma Inc., Napp Pharmaceuticals, Vifor Pharma Management Ltd. C. P. Cannon: Advisory Panel; Self; Aegerion Pharmaceuticals Inc., Amarin Corporation plc, Corvidia Therapeutics, Eli Lilly and Company, Janssen Pharmaceuticals, Inc., Merck & Co., Inc., Pfizer Inc., Sanofi, Consultant; Self; Alnylam Pharmaceuticals, Inc., Amgen Inc., Applied Therapeutics, Ascendis Pharma A/S, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, HLS Therapeutics Inc., Kowa Company, Ltd., Research Support; Self; Amgen Inc., Boehringer Ingelheim Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Daiichi Sankyo, Janssen Research & Development, LLC, Kowa Company, Ltd., Merck & Co., Inc., Novo Nordisk Pharma Ltd., Pfizer Inc.