Comparing the Effects of Canagliflozin vs. Glimepiride by Body Mass Index in Patients with Type 2 Diabetes and Chronic Heart Failure: A Subanalysis of the CANDLE Trial
2022
Akira Sezai | Atsushi Tanaka | Takumi Imai | Keisuke Kida | Hisakuni Sekino | Toyoaki Murohara | Masataka Sata | Norio Suzuki | Koichi Node
Background: We present results of a 24-week comparative study of the effects of the sodium–glucose cotransporter 2 (SGLT2) inhibitor canagliflozin vs. the sulfonylurea glimepiride, by baseline body mass index (BMI), in patients with type 2 diabetes and chronic heart failure. Methods: We conducted a post hoc analysis of the CANDLE trial. This subanalysis evaluated NT-proBNP, BMI, and other laboratory parameters, according to the subgroups stratified by BMI ≥ 25 kg/m<sup>2</sup> vs. BMI < 25 kg/m<sup>2</sup>. Results: A group ratio of proportional changes in the geometric means of NT-proBNP was 0.99 (<i>p</i> = 0.940) for the subgroup with BMI ≥ 25 kg/m<sup>2</sup> and 0.85 (<i>p</i> = 0.075) for the subgroup with BMI < 25 kg/m<sup>2</sup>, respectively. When baseline BMI was modeled as a continuous variable, results for patients with BMI < 30 kg/m<sup>2</sup> showed a slightly smaller increase in NT-proBNP in the canagliflozin group vs. the glimepiride group (<i>p</i> = 0.295); that difference was not seen among patients with BMI ≥30 kg/m<sup>2</sup> (<i>p</i> = 0.948). Irrespective of obesity, the canagliflozin group was associated with significant reduction in BMI compared to the glimepiride group. Conclusion: There was no significant difference in the effects of canagliflozin, relative to glimepiride, on NT-proBNP concentrations irrespective of baseline obesity. UMIN clinical trial registration number: UMIN000017669.
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