Efficacy and safety of canagliflozin are consistent across polypharmacy burden in CKD: the CREDENCE trial
Rattachement africain : au, hk, ca, my, in, gb, us, nl. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: Polypharmacy in chronic kidney disease (CKD) is substantial. Clinicians and patients are often reluctant to add medications to already complex regimens, partly due to concerns about diminishing efficacy and increased adverse effects. We assessed whether efficacy and safety of canagliflozin is modified by polypharmacy status in patients with type 2 diabetes and CKD. METHODS: We conducted a post-hoc analysis of the CREDENCE trial, which evaluated the effects of canagliflozin on outcomes in patients with type 2 diabetes and CKD. Participants were categorized as no polypharmacy (0-4 medicines), polypharmacy (5-9 medicines), or hyperpolypharmacy (≥10 medicines). We assessed the relative effects of canagliflozin on clinical and safety outcomes by polypharmacy status using Cox proportional hazards models. We assessed absolute benefits using Poisson regression. The primary outcome was a composite of doubling of serum creatinine, kidney failure or death due to cardiovascular or kidney disease. RESULTS: Among 4401 participants, 612 (14%), 2404 (55%), and 1385 (31%) were categorized as no polypharmacy, polypharmacy and hyperpolypharmacy, respectively. Mean number of medications was 8.3 (SD 3.77). The effect of canagliflozin on kidney and cardiovascular outcomes was consistent irrespective of polypharmacy status, with no interaction observed for safety outcomes (all P-interaction > 0.06). Rates of treatment discontinuation increased with medication burden, but were lower with canagliflozin versus placebo, regardless of polypharmacy status (P-interaction = 0.16). Incidence of all-cause hospitalization, and heart failure hospitalization or cardiovascular death increased with higher medication burden, thus absolute risk reductions were estimated to be substantially greater in patients with polypharmacy and hyperpolypharmacy. CONCLUSION: Among patients with type 2 diabetes and CKD, the efficacy and safety of canagliflozin appears consistent regardless of polypharmacy status, with larger estimated absolute reductions in hospitalizations and cardiovascular events in those experiencing polypharmacy or hyperpolypharmacy. These findings suggest that polypharmacy alone should not preclude consideration of SGLT2 inhibitor therapy in patients with CKD and type 2 diabetes for whom treatment is otherwise indicated.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Efficacy and safety of canagliflozin are consistent across polypharmacy burden in CKD: the CREDENCE trial
- Date Crossref
- 04/09/2026
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
The Royal Melbourne Hospital pays non établi dans la noticeOrganisme public
-
UNSW Sydney pays non établi dans la noticeUniversité ou école supérieure
-
Royal North Shore Hospital pays non établi dans la noticeÉtablissement de santé
-
University of Hong Kong pays non établi dans la noticeUniversité ou école supérieure
-
Monash Medical Centre pays non établi dans la noticeÉtablissement de santé
-
Monash University pays non établi dans la noticeUniversité ou école supérieure
-
Prince of Wales Hospital pays non établi dans la noticeÉtablissement de santé
-
St Vincent's Hospital Melbourne pays non établi dans la noticeÉtablissement de santé
-
St Vincent's Hospital Sydney pays non établi dans la noticeÉtablissement de santé
-
St Vincent’s Private Hospital Sydney pays non établi dans la noticeÉtablissement de santé
-
University of British Columbia Division of Nephrology pays non établi dans la noticeUniversité ou école supérieure
-
The University of Sydney NHMRC Clinical Trials Centre pays non établi dans la noticeUniversité ou école supérieure
The Royal Melbourne Hospital, UNSW Sydney et Royal North Shore Hospital, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.