AIMS Sodium glucose co-transporter 2 (SGLT2) inhibitors reduce several cardiovascular risk factors, including plasma glucose, blood pressure, albuminuria and body weight. Long-term treatment lowers risks of cardiovascular and renal events. The objective of this post hoc analysis was to determine the effects of canagliflozin treatment versus placebo on clinical outcomes in relation to body mass index (BMI). MATERIALS AND METHODS The CANVAS Program randomized 10 142 participants with type 2 diabetes to canagliflozin or placebo. These analyses tested the consistency of canagliflozin treatment effects across BMI levels for cardiovascular, renal, safety and body weight outcomes in three groups defined by baseline BMI: <25, 25-<30 and ≥30 kg/m2 . RESULTS In total, 10 128 participants with baseline BMI measurements were included. There were 966 participants with BMI <25 kg/m2 , 3153 with BMI 25-<30 kg/m2 and 6009 with BMI ≥30 kg/m2 . Mean percent body weight reduction with canagliflozin compared with placebo was greater at 12 months [-2.77%  (95% confidence interval (CI): -2.95, -2.59)] than at 3 months [-1.72%  (95% CI: -1.83, -1.62)]. The hazard ratios (HRs) for canagliflozin compared with placebo control for the composite outcome of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke were 1.03 (95% CI: 0.66, 1.59) in participants with BMI <25 kg/m2 , 0.97 (0.76, 1.23) with BMI 25-<30 kg/m2 and 0.79 (0.67, 0.93) with BMI ≥30 kg/m2 (P for heterogeneity = 0.55). The effects of canagliflozin on each component of the composite were also similar across BMI subgroups, as were effects on heart failure and renal outcomes (P for heterogeneity ≥0.19). The effects on safety outcomes were also broadly similar. CONCLUSIONS Canagliflozin improved cardiovascular and renal outcomes consistently across patients with a broad range of BMI levels.

中文翻译：

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根据基线体重指数得出的卡格列净临床结果：CANVAS 计划事后分析的结果。


目的 钠葡萄糖协同转运蛋白 2 (SGLT2) 抑制剂可降低多种心血管危险因素，包括血糖、血压、蛋白尿和体重。长期治疗可降低心血管和肾脏事件的风险。本事后分析的目的是确定卡格列净治疗与安慰剂相比对体重指数 (BMI) 相关临床结果的影响。材料和方法 CANVAS 计划将 10 142 名 2 型糖尿病患者随机分配至卡格列净或安慰剂组。这些分析测试了卡格列净在不同 BMI 水平下对心血管、肾脏、安全性和体重结果的治疗效果的一致性，这三组由基线 BMI 定义：<25、25-<30 和 ≥30 kg/m2。结果 总共纳入了 10 128 名具有基线 BMI 测量值的参与者。 BMI <25 kg/m2 的参与者有 966 名，BMI 25-<30 kg/m2 的参与者有 3153 名，BMI ≥30 kg/m2 的参与者有 6009 名。与安慰剂相比，卡格列净组的平均体重减轻百分比在 12 个月时 [-2.77%（95% 置信区间 (CI)：-2.95，-2.59）] 高于 3 个月时 [-1.72%（95% CI：-1.83）] ，-1.62)]。在 BMI <25 kg/m2 的参与者中，与安慰剂对照相比，卡格列净的心血管死亡、非致命性心肌梗死或非致命性卒中复合结局的风险比 (HR) 为 1.03 (95% CI: 0.66, 1.59) ，BMI 25-<30 kg/m2 时为 0.97 (0.76, 1.23)，BMI ≥30 kg/m2 时为 0.79 (0.67, 0.93)（异质性 P = 0.55）。卡格列净对各个 BMI 亚组的复合成分的影响也相似，对心力衰竭和肾脏结局的影响也相似（异质性 P ≥0.19）。对安全结果的影响也大致相似。 结论 对于不同 BMI 水平的患者，卡格列净均能持续改善心血管和肾脏结局。