Abstract

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).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 3 groups defined by baseline BMI: <25, 25-<30, and =30 kg/m2 .A total of 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 body weight reduction with canagliflozin compared to placebo was greater at 12 months (-2.47 kg [95% CI: -2.64, -2.30]) than at 3 months (-1.53 kg [95% CI: -1.63, -1.44]). The HRs (95% CI) for canagliflozin compared with placebo control for the composite outcome of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke were HR 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, renal, and safety outcomes (all P for heterogeneity =0.15).Canagliflozin improved cardiovascular and renal outcomes consistently across patients with a broad range of BMI levels. This article is protected by copyright. All rights reserved.

View details for DOI 10.1111/dom.13920

View details for PubMedID 31729107