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The highly anticipated kidney outcome study of the world's first hypoglycemic drug-the results of the CREDENCE study are really shocking! Studies have found that the SGLT2 inhibitor canagliflozin can not only significantly reduce the risk of renal events, but also reduce the risk of cardiovascular events, and at the same time has good safety
Significantly reduce the risk of renal events, and can also reduce the risk of cardiovascular events, while having good safety
Background: The relationship between early changes in proteinuria and renal and cardiovascular events is mainly based on the renin-angiotensin inhibitory system
Methods: Canagliflozin and Diabetic Nephropathy Clinical Evaluation (CREDENCE) trial included 4401 patients with type 2 diabetes and CKD (urinary albumin-creatinine ratio [UACR]>300 mg/g)
diabetes
Compared with placebo, canagliflozin reduced the UACR by 31% (95% confidence interval [95% CI], 27% to 36%) at 26 weeks , and significantly increased the possibility of a 30% reduction in UACR (advantage Ratio [OR], 2.
Canagliflozin reduced UACR by 31% in 26 weeks and significantly increased the likelihood of a 30% reduction in UACR
Figure 1 From the 26th week, canagliflozin reduced the possibility of proteinuria progressing to nephropathy (group A) and increased the possibility of proteinuria regression (group B)
Canagliflozin can reduce the probability of proteinuria by ≥30% (OR, 0.
Every 30% reduction in UACR in the first 26 weeks is independently associated with a reduction in the prognostic risk of primary kidney disease (hazard ratio [HR], 0.
Every 30% reduction in UACR in the first 26 weeks is independently associated with a reduction in the prognostic risk of primary kidney disease
Figure 2 Early changes in proteinuria at week 26 were independently associated with (A) comprehensive renal outcome, (B) MACE, and (C) the risk of death from HHF/CV
The number above each circle represents the rate of occurrence of UACR changes
In general, in each treatment group, the level of residual proteinuria at week 26 was still a strong independent risk factor for renal and cardiovascular events
The level of residual proteinuria remains a strong independent risk factor for renal and cardiovascular events
CONCLUSION: In patients with type 2 diabetes and CKD, the use of canagliflozin can continuously reduce early proteinuria, which is independently related to long-term renal and cardiovascular prognosis
In patients with type 2 diabetes and CKD, the use of canagliflozin can lead to a sustained reduction in early proteinuria, which is independently related to long-term renal and cardiovascular prognosis
Original source:
Original source:Oshima M, Neuen BL, Li J, et al.
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