The new guidance was co-published in Diabetologia, the journal of EASD, and Diabetes Care, the journal of the ADA, during the annual meeting of EASD in Berlin, Germany on October 5.
Updates to the guidance took into consideration recent evidence from large CV outcome trials (CVOTs), which included the CANVAS programme, the largest completed and published CV outcomes trial to date for an SGLT2i, which has shown that canagliflozin reduces the risk of major adverse cardiovascular events including CV mortality, non-fatal myocardial infarction or non-fatal stroke in patients with T2DM who had either a history of CV disease or at least two CV risk factors, as well as reducing hospitalisation for heart failure and demonstrating improved renal outcomes.
The positioning of canagliflozin within the Consensus Report has been supported by the recent European Commission approval to expand the canagliflozin label which was based on the positive results from the CANVAS Programme.
The study included 10,142 patients with a history of CV disease or at least two risk factors of a CV event and showed canagliflozin met the primary outcome demonstrating a reduction in the combined risk of major adverse CV events by 14% and, as a secondary outcome, a HHF reduction of 33%.
In addition, there were renal outcomes benefits, seen as a reduction in the doubling of serum creatinine, the need for renal-replacement therapy and renal death by 47%.
The study also demonstrated a 27% reduction in the progression of albuminuria in people with T2DM with either a history of CV disease or at least two CV risk factors.3,4 Canagliflozin provided sustained positive effects on glycaemic and blood pressure control, as well as weight reduction, demonstrating wide-ranging durability.
The American Diabetes Association and European Association for the Study of Diabetes convened a panel to update the position statements, published in 2012 and 2015, on the management of T2DM in adults. The updated consensus paper was co-published in Diabetologia, the journal of EASD, and Diabetes Care, the journal of the ADA, during the annual meeting of EASD in Berlin, Germany on 5th October 2018.
Major changes from prior consensus reports are based on new evidence from large CV outcome trials which have shown that specific SGLT2 inhibitors or glucagon-like peptide-1 (GLP-1) receptor agonists improve CV outcomes, as well as secondary outcomes such as HF and progression of renal disease, in patients with established CVD or CKD.
Invokana (canagliflozin) is an oral, once-daily medication which belongs to a new class of medications called sodium glucose co-transporter 2 (SGLT2) inhibitors.
SGLT2 inhibitors work by inhibiting SGLT2, which promotes the loss of glucose via the urine, lowering blood glucose levels in adults with T2DM.
Canagliflozin was approved in the European Union by the European Commission in November 2013.
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