Evidence map›SGLT2 inhibitors × cardiac & vascular function›PMID 32349193›Full record

Trial reportESC heart failure2020

Effects of canagliflozin in patients with type 2 diabetes and chronic heart failure: a randomized trial (CANDLE).

Atsushi Tanaka, Itaru Hisauchi, Isao Taguchi, Akira Sezai, Shigeru Toyoda, Hirofumi Tomiyama, Masataka Sata, Shinichiro Ueda, Jun-Ichi Oyama, Masafumi Kitakaze and 3 more

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in ESC heart failure, 2020. The graph read 2 numbers from its abstract, feeding 1 cell of the map: it . Cited by 53 papers, 18 of them syntheses that pooled it.

2numbers the graph read from it
1cell of the map it votes in
53citing papers in PubMed, 18 pooled it
10.9field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

← favours the treatmentfavours the comparator →
-15911.00 · no effect
NT-proBNP levelscanagliflozin vs glimepirideno clear difference · t2d, heart_failurefeeds one cell of the map
Δ -74.7-159 to 10.9N/A
However, NT-proBNP levels did show a non-significant trend lower in the canagliflozin group [adjusted group difference; -74.7 pg/mL (95% CI, -159.3 to 10.9), P = 0.087] and also in the subgroup with preserved LVEF [-58.3 (95% CI, -127.6 to 11.0, P = 0.098]).

The authors add: did show a non-significant trend lower

FeedsSGLT2 inhibitors×cardiac & vascular function
NT-proBNP levelscanagliflozin vs glimepiride, in preserved LVEFno clear difference · t2d, heart_failurefeeds one cell of the map
Δ -58.3-128 to 11.0N/A
However, NT-proBNP levels did show a non-significant trend lower in the canagliflozin group [adjusted group difference; -74.7 pg/mL (95% CI, -159.3 to 10.9), P = 0.087] and also in the subgroup with preserved LVEF [-58.3 (95% CI, -127.6 to 11.0, P = 0.098]).

The authors add: did show a non-significant trend lower

FeedsSGLT2 inhibitors×cardiac & vascular function

clause the extractor read what became the number

2 · Its place on the map

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.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

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×cardiac & vascular function

No readable resultOpen on the map →What to test next →

12 readable studies in this cell: 6 favour the treatment, 6 find no difference, 0 favour the comparator.

Belief with this paper
0.50contested · 6 families support, 3 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the comparatorfavours the treatment →
0 · no effect
This paper · 2020
Δ -74.7-159 to 10.9
NCT030579515,988 enrolled · 2017
Δ 1.320.45 to 2.19
NCT030579773,730 enrolled · 2017
Δ 2.060.16 to 3.96
NCT04252287476 enrolled · 2020
Δ 4.300.80 to 7.80
NCT03448406315 enrolled · 2018
Δ 4.00-5.00 to 13.0
NCT03448419312 enrolled · 2018
Δ -4.00-16.0 to 6.00
NCT0297347745 enrolled · 2017
Coefficient 0.01-0.23 to 0.25
4 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

53 citing papers in PubMed, 18 syntheses or guidelines pooled it, 106 citations in OpenAlex.

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6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

13 authors at 9 institutions in 1 country.

Atsushi TanakaDepartment of Cardiovascular Medicine, Saga University, Saga, Japan.
Itaru HisauchiDepartment of Cardiology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.
Isao TaguchiDepartment of Cardiology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.
Akira SezaiThe Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
Shigeru ToyodaDepartment of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, Mibu, Japan.
Hirofumi TomiyamaDepartment of Cardiology, Tokyo Medical University, Tokyo, Japan.
Masataka SataDepartment of Cardiovascular Medicine, Tokushima University Graduate School, Tokushima, Japan.
Shinichiro UedaDepartment of Clinical Pharmacology and Therapeutics, University of the Ryukyus, Nishihara, Japan.
Jun-Ichi OyamaDepartment of Cardiovascular Medicine, Saga University, Saga, Japan.
Masafumi KitakazeDepartment of Clinical Medicine and Development, National Cerebral and Cardiovascular Center, Suita, Japan.
Toyoaki MuroharaDepartment of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Koichi NodeDepartment of Cardiovascular Medicine, Saga University, Saga, Japan.
CANDLE Trial Investigators
Saga University · JPDokkyo Medical University · JPDokkyo Medical University Saitama Medical Center · JPNagoya University · JPNational Cerebral and Cardiovascular Center · JPNihon University · JPTokushima University · JPTokyo Medical University · JPUniversity of the Ryukyus · JP

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

aimsLittle is known about the impact of sodium glucose co-transporter 2 (SGLT2) inhibitors on cardiac biomarkers, such as natriuretic peptides, in type 2 diabetes (T2D) patients with concomitant chronic heart failure (CHF). We compared the effect of canagliflozin with glimepiride, based on changes in N-terminal pro-brain natriuretic peptide (NT-proBNP), in that patient population. METHODS AND

resultsPatients with T2D and stable CHF, randomized to receive canagliflozin 100 mg or glimepiride (starting-dose: 0.5 mg), were examined using the primary endpoint of non-inferiority of canagliflozin vs. glimepiride, defined as a margin of 1.1 in the upper limit of the two-sided 95% confidence interval (CI) for the group ratio of percentage change in NT-proBNP at 24 weeks. Data analysis of 233 patients showed mean left ventricular ejection fraction (LVEF) at randomization was 57.6 ± 14.6%, with 71% of patients having a preserved LVEF (≥50%). Ratio of NT-proBNP percentage change was 0.48 (95% CI, -0.13 to 1.59, P = 0.226) and therefore did not meet the prespecified non-inferiority margin. However, NT-proBNP levels did show a non-significant trend lower in the canagliflozin group [adjusted group difference; -74.7 pg/mL (95% CI, -159.3 to 10.9), P = 0.087] and also in the subgroup with preserved LVEF [-58.3 (95% CI, -127.6 to 11.0, P = 0.098]).

conclusionsThis study did not meet the predefined primary endpoint of changes in NT-proBNP levels, with 24 weeks of treatment with canagliflozin vs. glimepiride. Further research is warranted to determine whether patients with heart failure with preserved ejection fraction, regardless of diabetes status, could potentially benefit from treatment with SGLT2 inhibitors.

Indexed as

Diabetes Mellitus, Type 2Heart FailureCanagliflozinHumansNatriuretic Peptide, BrainStroke VolumeVentricular Function, LeftCanagliflozinNatriuretic Peptide, BrainGlimepirideHeart failureNon-inferiorityNT-proBNPSGLT2 inhibitorType 2 diabetes

Identifiers

PMID32349193
PMCPMC7373938
OpenAlexW3018301168

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.