Trial reportThe New England journal of medicine2017
Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes.
Trial report in The New England journal of medicine, 2017. The graph read 3 numbers from its abstract, feeding 2 cells of the map: it . It reports registered trial NCT01032629. Cited by 3,183 papers, 21 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
Adverse reactions were consistent with the previously reported risks associated with canagliflozin except for an increased risk of amputation (6.3 vs. 3.4 participants per 1000 patient-years; hazard ratio, 1.97; 95% CI, 1.41 to 2.75); amputations were primarily at the level of the toe or metatarsal.
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Although on the basis of the prespecified hypothesis testing sequence the renal outcomes are not viewed as statistically significant, the results showed a possible benefit of canagliflozin with respect to the progression of albuminuria (hazard ratio, 0.73; 95% CI, 0.67 to 0.79) and the composite outcome of a sustained 40% reduction in the estimated glomerular filtration rate, the need for renal-replacement therapy, or death from renal causes (hazard ratio, 0.60; 95% CI, 0.47 to 0.77).
Although on the basis of the prespecified hypothesis testing sequence the renal outcomes are not viewed as statistically significant, the results showed a possible benefit of canagliflozin with respect to the progression of albuminuria (hazard ratio, 0.73; 95% CI, 0.67 to 0.79) and the composite outcome of a sustained 40% reduction in the estimated glomerular filtration rate, the need for renal-replacement therapy, or death from renal causes (hazard ratio, 0.60; 95% CI, 0.47 to 0.77).
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Where it lands on the map
Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.
What it adds to each cell
For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.
SGLT2 inhibitors×cardiovascular events
No readable resultOpen on the map →What to test next →22 readable studies in this cell: 9 favour the treatment, 10 find no difference, 3 favour the comparator.
SGLT2 inhibitors×kidney outcomes
No readable resultOpen on the map →What to test next →13 readable studies in this cell: 10 favour the treatment, 1 find no difference, 2 favour the comparator.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized, Multicenter, Double-Blind, Parallel, Placebo-Controlled Study of the Effects of JNJ-28431754 on Cardiovascular Outcomes in Adult Subjects With Type 2 Diabetes Mellitus
Open the trial in the graphA Randomized, Multicenter, Double-Blind, Parallel, Placebo-Controlled Study of the Effects of Canagliflozin on Renal Endpoints in Adult Subjects With Type 2 Diabetes Mellitus
Open the trial in the graphDapagliflozin Effects on Mayor Adverse Cardiovascular Events in Patients With Acute Myocardial Infarction (DAPA-AMI). Randomized Clinical Trial
CardioRenal Effects of SGLT2 Inhibition in Kidney Transplant Recipients
Open the trial in the graphCanagliflozin Attenuates CMR-Quantified Myocardial Fibrosis in Patients With Type 2 Diabetes Mellitus at High Cardiovascular Risk
Prospective Observational Cohort Study to Evaluate the Benefits, Documented in the Experimental Settings, of Treatment With SGLT2-i in Normal Clinical Practice, in Subjects With Type 2 Diabetes and Older Than 70 Years.
Open the trial in the graphAn Open-Label, Non-randomized, Multi-center Pilot Study to Evaluate the Safety and Efficacy of 4-week, Daily Oral Use of Dapagliflozin 10mg Tablet in Adults With a Fontan Circulation
Pleiotropic Effects of Dapagliflozin in Patients With Acute Coronary Syndromes
Dapagliflozin to Prevent Atrial Fibrillation Recurrence After Transcatheter Pulmonary Venous Isolation.
Healthy China - The Improvement Projects for the Screening Ability of Diabetes and Its Complications And for the Standardized Ability of Diagnosis and Treatment for Patients With Early Diabetic Nephropathy
Effects and Safety of GUideline Algorithm Based Intervention on CaRdiovascular and Renal Outcomes in Elderly Diabetic Patients With High Cardiovascular Risk in the Community- A Cluster Randomized Controlled Trial (GUARD-Community Study)
Impact of DApagliflozin on Cardiac Function Following Anterior Myocardial Infarction in Non-Diabetic Patients - DACAMI (a Randomized Controlled Clinical Trial)
Efficacy and Safety of Sodium-Glucose Cotransporter 2 Inhibitors in Adults With Sepsis: A Feasibility Study for a Multicenter Double-Blind Randomized Placebo-Controlled Trial
Who cites it
3,183 citing papers in PubMed, 21 syntheses or guidelines pooled it.
- Are SGLT2 inhibitors really associated with increased urinary tract infection risk? A trial-level meta-analysis across type 2 diabetes, heart failure, and chronic kidney disease.Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 2026Pooled it
- Cardiovascular and renal outcomes of combined SGLT2 inhibitors and GLP-1 receptor agonists versus monotherapy in patients with type 2 diabetes mellitus: a network meta-analysis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2026Pooled it
- SGLT2 inhibitors are associated with reductions in epicardial adipose tissue volume and thickness: a meta-analysis.International journal of obesity (2005) · 2026Pooled it
- 2026 AHA/ACC/ADA/ASN Guideline for the Prevention, Detection, Evaluation, and Management of Cardiovascular-Kidney-Metabolic Syndrome: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.Journal of the American College of Cardiology · 2026Guideline
- Interrelationship Between Baseline HbA1c, SGLT-2 Inhibitor Use and Risk of Diabetic Ketoacidosis in Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis.Diabetes, obesity & metabolism · 2026Pooled it
- Cardiovascular, limb, and kidney effects of SGLT2 inhibitors in patients with peripheral artery disease: a systematic review and meta-analysis of randomized controlled trial data.Cardiovascular diabetology · 2026Pooled it
- Association of glomerular hyperfiltration with mortality in stroke: an analysis using pooled individual patient data.European stroke journal · 2026Pooled it
- [Individualizing antihypertensive therapy in diabetes mellitus. Guidelines of the Austrian Diabetes Association (Update 2026)].Wiener klinische Wochenschrift · 2026Guideline
- [Diabetic kidney disease (Update 2026) : Guidelines in a collaboration of the Austrian Diabetes Association and the Austrian Society of Nephrology].Wiener klinische Wochenschrift · 2026Guideline
- The Effects of SGLT2 Inhibitors on Muscle Health in Older Adults: A Systematic Review and Meta-Analysis.Pharmacology research & perspectives · 2026Pooled it
- Sex differences in trial representation and the cardiovascular effectiveness of newer glucose-lowering agents in patients with and without type 2 diabetes: A systematic review and meta-analysis of cardiovascular outcome trials.Diabetes, obesity & metabolism · 2026Pooled it
- Pooled it
- Sodium-glucose cotransporter-2 inhibitors and risk of diabetic retinopathy in type 2 diabetes: a network meta-analysis of randomised clinical trials.International journal of clinical pharmacy · 2026Pooled it
- SGLT2 Inhibitors and Kidney Outcomes by Glomerular Filtration Rate and Albuminuria: A Meta-Analysis.JAMA · 2026Pooled it
- 2026 ACC/AHA Clinical Performance and Quality Measures for Patients With Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Performance Measures.Journal of the American College of Cardiology · 2026Guideline
- 10. Cardiovascular Disease and Risk Management: Standards of Care in Diabetes-2026.Diabetes care · 2026Guideline
- Comparison of the renal outcomes of novel antidiabetic agents in patients with type 2 diabetes with chronic kidney disease: A systematic review and network meta-analysis of randomized controlled trials.Diabetes, obesity & metabolism · 2026Pooled it
- Safety evaluation of Sodium-glucose cotransporter 2 inhibitors for cancer risk in specific populations: systematic review and meta-analysis.Frontiers in clinical diabetes and healthcare · 2026Pooled it
- Genetic Evidence for the Benefits and Risks of Glucose-Lowering Drugs on Cardiovascular-Kidney-Metabolic Syndrome: A Drug-Target Mendelian Randomization Study.International journal of medical sciences · 2026 · on this mapPooled it
- Application of SGLT2 inhibitors in kidney diseases: a bibliometric analysis.Frontiers in medicine · 2026Pooled it
3,123 more citing papers are in PubMed but not listed here.
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The marked sentences are the ones the graph read a number from.
Background Canagliflozin is a sodium-glucose cotransporter 2 inhibitor that reduces glycemia as well as blood pressure, body weight, and albuminuria in people with diabetes. We report the effects of treatment with canagliflozin on cardiovascular, renal, and safety outcomes. Methods The CANVAS Program integrated data from two trials involving a total of 10,142 participants with type 2 diabetes and high cardiovascular risk. Participants in each trial were randomly assigned to receive canagliflozin or placebo and were followed for a mean of 188.2 weeks. The primary outcome was a composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. Results The mean age of the participants was 63.3 years, 35.8% were women, the mean duration of diabetes was 13.5 years, and 65.6% had a history of cardiovascular disease. The rate of the primary outcome was lower with canagliflozin than with placebo (occurring in 26.9 vs. 31.5 participants per 1000 patient-years; hazard ratio, 0.86; 95% confidence interval [CI], 0.75 to 0.97; P<0.001 for noninferiority; P=0.02 for superiority). Although on the basis of the prespecified hypothesis testing sequence the renal outcomes are not viewed as statistically significant, the results showed a possible benefit of canagliflozin with respect to the progression of albuminuria (hazard ratio, 0.73; 95% CI, 0.67 to 0.79) and the composite outcome of a sustained 40% reduction in the estimated glomerular filtration rate, the need for renal-replacement therapy, or death from renal causes (hazard ratio, 0.60; 95% CI, 0.47 to 0.77). Adverse reactions were consistent with the previously reported risks associated with canagliflozin except for an increased risk of amputation (6.3 vs. 3.4 participants per 1000 patient-years; hazard ratio, 1.97; 95% CI, 1.41 to 2.75); amputations were primarily at the level of the toe or metatarsal. Conclusions In two trials involving patients with type 2 diabetes and an elevated risk of cardiovascular disease, patients treated with canagliflozin had a lower risk of cardiovascular events than those who received placebo but a greater risk of amputation, primarily at the level of the toe or metatarsal. (Funded by Janssen Research and Development; CANVAS and CANVAS-R ClinicalTrials.gov numbers, NCT01032629 and NCT01989754 , respectively.).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.