Evidence map›SGLT2 inhibitors × kidney outcomes›PMID 32998938›Full record

Trial reportJournal of the American Society of Nephrology : JASN2020

Early Change in Albuminuria with Canagliflozin Predicts Kidney and Cardiovascular Outcomes: A

Megumi Oshima, Brendon L Neuen, JingWei Li, Vlado Perkovic, David M Charytan, Dick de Zeeuw, Robert Edwards, Tom Greene, Adeera Levin, Kenneth W Mahaffey and 6 more

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American Society of Nephrology : JASN, 2020. The graph read 2 numbers from its abstract, feeding 1 cell of the map: it supports the treatment in 1. It also reports an association that does not count as treatment evidence, such as HR 0.71 (0.67 to 0.76) for kidney outcomes. Cited by 90 papers, 6 of them syntheses that pooled it.

2numbers the graph read from it
1cell of the map it votes in
90citing papers in PubMed, 6 pooled it
13.3field-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 comparatorfavours the treatment →
21 · no effect
Kidney outcomesfavours the treatment · against placebo · ckd, ascvdfeeds one cell of the map
OR 2.692.35 to 3.07
Compared with placebo, canagliflozin lowered UACR by 31% (95% confidence interval [95% CI], 27% to 36%) at week 26, and significantly increased the likelihood of achieving a 30% reduction in UACR (odds ratio, 2.69; 95% CI, 2.35 to 3.07).
FeedsSGLT2 inhibitors×kidney outcomes

Read, but not usablea number the graph found but could not read as for or against

Kidney outcomesan association or prognostic statement, not a treatment comparison · ckd, ascvdfeeds one cell of the map
HR 0.710.67 to 0.76
Each 30% decrease in UACR over the first 26 weeks was independently associated with a lower hazard for the primary kidney outcome (hazard ratio [HR], 0.71; 95% CI, 0.67 to 0.76; CONCLUSIONS: In people with type 2 diabetes and CKD, use of canagliflozin results in early, sustained reductions in albuminuria, which were independently associated with long-term kidney and cardiovascular outcomes.
FeedsSGLT2 inhibitors×kidney outcomes

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×kidney outcomes

SupportsOpen 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.

Belief with this paper
0.89established · 8 families support, 1 contradict · against placebo
Without it
0.88This paper moves it by +0.01.
← favours the comparatorfavours the treatment →
1 · no effect
This paper · 2020
OR 2.692.35 to 3.07
NCT02864914333,580 enrolled · 2016
IRR 0.690.45 to 1.05
NCT0546531762,197 enrolled · 2022
HR 0.750.65 to 0.86
NCT0173053417,190 enrolled · 2013
HR 0.760.67 to 0.87
NCT030579515,988 enrolled · 2017
Treatment by time interaction 1.360.86 to 1.86
NCT019897545,813 enrolled · 2014
HR 0.640.57 to 0.73
NCT020657914,401 enrolled · 2014
HR 0.700.59 to 0.82
NCT010326294,330 enrolled · 2009
OR 0.800.67 to 0.97
NCT030579773,730 enrolled · 2017
Treatment by time interaction 1.730.67 to 2.80
Insights from CREDENCE trial indicate an acute drop in estimated glome…PMID 33316282 · 2021
OR 3.032.65 to 3.47
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

90 citing papers in PubMed, 6 syntheses or guidelines pooled it, 165 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Trial
  9. Trial
  10. Trial
  11. Trial
  12. Trial
  13. Trial
  14. Article
  15. Review
  16. Review
  17. Review
  18. Review
  19. Review
  20. Review

30 more citing papers are in PubMed but not listed here.

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

16 authors at 10 institutions in 6 countries.

Megumi OshimaThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.ORCID 0000-0002-4108-5229
Brendon L NeuenThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.ORCID 0000-0001-9276-8380
JingWei LiThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia h.j.lambers.heerspink@umcg.nl.
Vlado PerkovicThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.
David M CharytanNephrology Division, School of Medicine and Langone Medical Center, New York University, New York, New York.ORCID 0000-0002-7695-3583
Dick de ZeeuwDepartment of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Robert EdwardsJanssen Research & Development, LLC, Raritan, New Jersey.
Tom GreeneDivision of Biostatistics, Department of Population Health Sciences, University of Utah, Salt Lake City, Utah.ORCID 0000-0002-3706-7570
Adeera LevinDivision of Nephrology, University of British Columbia, Vancouver, Canada.
Kenneth W MahaffeyStanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, Stanford, California.
Luca De NicolaDepartment of Advanced Medical and Surgical Sciences, Nephrology and Dialysis Unit, University Vanvitelli, Naples, Italy.
Carol PollockKolling Institute of Medical Research, Sydney Medical School, University of Sydney, Royal North Shore Hospital, St Leonards, Australia.
Norman RosenthalJanssen Research & Development, LLC, Raritan, New Jersey.
David C WheelerThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.
Meg J JardineThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia.
Hiddo J L HeerspinkThe George Institute for Global Health, University of New South Wales Sydney, Sydney, Australia h.j.lambers.heerspink@umcg.nl.
UNSW Sydney · AUJanssen (United States) · USUniversity Medical Center Groningen · NLCenter for Clinical Research (United States) · USConcord Repatriation General Hospital · AUKanazawa University · JPNYU Langone Health · USThe University of Sydney · AUUniversity of British Columbia · CAUniversity of Utah · US

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.

backgroundThe association between early changes in albuminuria and kidney and cardiovascular events is primarily based on trials of renin-angiotensin system blockade. It is unclear whether this association occurs with sodium-glucose cotransporter 2 inhibition.

methodsThe Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial enrolled 4401 patients with type 2 diabetes and CKD (urinary albumin-creatinine ratio [UACR] >300 mg/g). This

resultsComplete data for early change in albuminuria and other covariates were available for 3836 (87.2%) participants in the CREDENCE trial. Compared with placebo, canagliflozin lowered UACR by 31% (95% confidence interval [95% CI], 27% to 36%) at week 26, and significantly increased the likelihood of achieving a 30% reduction in UACR (odds ratio, 2.69; 95% CI, 2.35 to 3.07). Each 30% decrease in UACR over the first 26 weeks was independently associated with a lower hazard for the primary kidney outcome (hazard ratio [HR], 0.71; 95% CI, 0.67 to 0.76;

conclusionsIn people with type 2 diabetes and CKD, use of canagliflozin results in early, sustained reductions in albuminuria, which were independently associated with long-term kidney and cardiovascular outcomes.

Indexed as

AgedAlbuminuriaCanagliflozinCardiovascular DiseasesDiabetes Mellitus, Type 2Diabetic NephropathiesDouble-Blind MethodFemaleHospitalizationHumansMaleMiddle AgedRenal Insufficiency, ChronicSodium-Glucose Transporter 2 InhibitorsCanagliflozinSodium-Glucose Transporter 2 Inhibitorsalbuminuriacanagliflozinkidney and cardiovascular outcomesSGLT2 inhibitor

Identifiers

PMID32998938
PMCPMC7790219
OpenAlexW3089612515

What Socratic holds

Texttitle and abstract
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.