Abstract Objective: We aimed to evaluate the efficacy of canagliflozin for the treatment of specific cardiovascular and renal outcomes in Type 2 diabetes mellitus (T2DM) patients by means of a systematic review and meta-analysis. Methods: We performed comprehensive searches of PubMed, the Cochrane Library, and Embase for randomized, placebo-controlled trials of the treatment of T2DM with canagliflozin that were published to 28 September 2020. The cardiovascular outcomes recorded were cardiovascular mortality, heart failure, myocardial infarction, and stroke. The renal composite outcomes recorded were end-stage renal disease (ESRD), renal death. The data for the principal cardiovascular outcomes, ESRD, and renal death were pooled and expressed as Hazard ratios (HRs) with 95% confidence intervals (CIs). Two reviewers independently selected the trials and extracted the data. Results: The meta-analysis showed that canagliflozin significantly reduced the risk of heart failure in T2DM by 36% (HR 0.64, 95% CI 0.53 to 0.77, p=0.000). The effects of canagliflozin on non-fatal myocardial infarction or non-fatal stroke (HR 0.84, 95% CI: 0.76 to 0.93, p=0.001), cardiovascular mortality (HR 0.84, 95% CI 0.72 to 0.97, p=0.021), and myocardial infarction (HR 0.84, 95% CI 0.70 to 1.00, p=0.045) in patients with T2DM were relatively small, only reducing the risks by 16%. In addition, canagliflozin only reduced the risk of stroke in T2DM patients by 13% (HR 0.87, 95% CI 0.71 to 1.06, p=0.166).Moreover, canagliflozin significantly reduced the risk of the composite renal event of ESRD or renal death by 36% (HR 0.64, 95% CI 0.54 to 0.75, p=0.000). Conclusions: This meta-analysis suggests that canagliflozin protects against cardiovascular and renal outcomes in patients with T2DM.

中文翻译：

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卡格列净预防 2 型糖尿病心血管和肾脏结局：随机对照试验的系统评价和荟萃分析

摘要 目的：我们旨在通过系统评价和荟萃分析评估卡格列净对 2 型糖尿病 (T2DM) 患者特定心血管和肾脏结局的治疗效果。方法：我们对 PubMed、Cochrane 图书馆和 Embase 进行了全面搜索，以寻找发布至 2020 年 9 月 28 日的卡格列净治疗 T2DM 的随机、安慰剂对照试验。记录的心血管结局包括心血管死亡率、心力衰竭、心肌梗塞，和中风。记录的肾脏复合结局是终末期肾病 (ESRD)、肾性死亡。将主要心血管结局、ESRD 和肾脏死亡的数据汇总并表示为具有 95% 置信区间 (CI) 的风险比 (HR)。两名评价员独立选择试验并提取数据。结 卡格列净对非致死性心肌梗死或非致死性卒中（HR 0.84，95% CI：0.76 至 0.93，p=0.001）、心血管死亡率（HR 0.84，95% CI 0.72 至 0.97，p=0.021）的影响， T2DM 患者的心肌梗死 (HR 0.84, 95% CI 0.70 至 1.00, p=0.045) 相对较小，仅将风险降低了 16%。此外，canagliflozin 仅将 T2DM 患者的卒中风险降低了 13%（HR 0.87，95% CI 0.71 至 1.06，p=0.166）。此外，canagliflozin 显着降低了 ESRD 或肾死亡复合肾脏事件的风险36%（HR 0.64，95% CI 0.54 至 0.75，p=0.000）。结论：