2220-PUB: Renal Outcomes Associated with Canagliflozin 100mg and with Intensification of SGLT2 Inhibitor Therapy Switching to Canagliflozin 300mg in Patients with Type 2 Diabetes Mellitus in a Real-World Setting: The Renal-WECAN Study

The aim of this multicentric retrospective study was to assess in a real-world setting kidney outcomes associated with canagliflozin 100 mg/d (CANA100), as add-on to the background antihyperglycemic therapy, and with the intensification of SGLT2 inhibitor (SGLT2i) therapy by switching to canagliflozin 300 mg/d (CANA300) in patients with T2DM. 583 patients were included, 279 with CANA100 (eGFR 86.5 ml/min, eGFR30 mg/g 25.7%) and 304 with CANA 300 (eGFR 84.9 ml/min, eGFR30 mg/g 20.7%). Median follow-up periods in both cohorts were 9.1 and 15.4 months respectively. The primary outcomes of the study were changes in eGFR, albuminuria and systolic BP (SBP) over the follow-up time. CANA100 was associated to significant reductions in eGFR (-2 ml/min) and SBP (-4.8 mmHg). In those patients with SBP>140 mmHg, CANA 100 lowered SBP levels by 14.9 mmHg. No significant changes in albuminuria were observed. However, in the subset of patients with baseline albuminuria >30 mg/gr, there was a significant decrease in median albuminuria. In the second cohort, patients with prior background SGLT2i therapy switched to CANA300. Significant reductions in eGFR (-1.8 ml/min), SBP (-3.2 mmHg), and median albuminuria (from 8.1 to 5.8 mg/g) were observed over the follow-up period. In those patients with SBP>140 mmHg, CANA 300 lowered SBP levels by 15.9 mmHg. In the subset with baseline albuminuria >30 mg/g, there was a significant decrease in median albuminuria. No significant changes in anti-hypertensive medications were observed over the follow-up. There was a low rate of adverse events related to volume depletion. In summary, CANA100 (as add-on therapy) and CANA300 (switching from CANA100 or other SGLT2i) significantly decreased SBP and modestly reduced eGFR. A significant reduction in albuminuria was observed with CANA300.