OBJECTIVE The study was undertaken because it was unknown whether the duration of type 2 diabetes modifies the effects of sodium–glucose cotransporter 2 inhibitor canagliflozin on cardiovascular (CV) and kidney outcomes. RESEARCH DESIGN AND METHODS This post hoc analysis of the CANagliflozin cardioVascular Assessment Study (CANVAS) Program (N = 10,142) and Evaluation of the Effects of Canagliflozin on Renal and Cardiovascular Outcomes in Participants With Diabetic Nephropathy (CREDENCE) trial (N = 4,401) evaluated hazard ratios and 95% CIs using Cox proportional hazards for the effects of canagliflozin on CV and kidney outcomes, including progression and regression of albuminuria over 5-year intervals of disease duration. RESULTS Canagliflozin had ranges of benefit across intervals of diabetes duration, with no heterogeneity for major adverse CV events, CV death or heart failure hospitalization, and kidney failure requiring therapy or doubling serum creatinine. Furthermore, canagliflozin reduced albuminuria progression and increased albuminuria regression with no interaction across all diabetes duration subgroups. CONCLUSIONS Our findings suggest that earlier treatment with canagliflozin confers consistent cardiorenal benefits to individuals with type 2 diabetes.

中文翻译：

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卡格列净对 2 型糖尿病持续时间的肾脏和心血管结果的影响：CANVAS 计划和 CREDENCE 试验的汇总分析

目的进行这项研究是因为尚不清楚 2 型糖尿病的持续时间是否会改变钠-葡萄糖协同转运蛋白 2 抑制剂卡格列净对心血管 (CV) 和肾脏结局的影响。研究设计和方法 这项事后分析对 CANagliflozin 心血管评估研究 (CANVAS) 计划 (N = 10,142) 和 Canagliflozin 对糖尿病肾病 (CREDENCE) 试验 (N = 4,401) 受试者的肾脏和心血管结局的影响进行了评估使用 Cox 比例风险计算卡格列净对心血管和肾脏结局影响的风险比和 95% CI，包括病程 5 年间隔内白蛋白尿的进展和消退。结果 卡格列净在不同的糖尿病病程中具有不同程度的益处，在主要不良心血管事件、心血管死亡或心力衰竭住院治疗以及需要治疗或血清肌酐加倍的肾衰竭方面没有异质性。此外，卡格列净可减少白蛋白尿的进展并增加白蛋白尿的消退，并且在所有糖尿病病程亚组中没有相互作用。结论 我们的研究结果表明，早期使用卡格列净治疗可为 2 型糖尿病患者带来一致的心肾益处。