Aim: To compare the efficiency of canagliflozin (C1) 100mg vs. canagliflozin (C3) 300mg on highly sensitive C reactive protein (hs-CRP) and other cardio-renal (CR) biomarkers.

Methodology: Between July and Sept 2018, a cohort of 190 T2DM patients aged 18-75 yrs, irrespective of baseline A1c, receiving SGLTi C1 or C3 were identified. A propensity score 1:1 matching was done for both the groups with variables that could affect treatment outcomes and to minimise confounding. Patients were evaluated every 2-3months for CR biomarkers (body mass index (BMI), A1c, systolic (S) BP, diastolic (D) BP, Lipid profile (TC, LDL, TG, HDL), Hs-CRP, creatinine, eGFR and urinary albumin/creatinine ratio {UACR}). NT-ProBNP was evaluated at 12 months. T2DM with history of IHD, revasularisation, major surgery, hyperkalemia >5.5Meq/L and eGFR<45 were excluded. Baseline characteristics were analyzed using descriptive statistics expressed as % or mean±SD. Comparison between the groups was performed using paired and unpaired t-test expressed as mean ± SE and p value <0.05 was considered significant(S). For interaction between drug class, ANOVA was used.

Results: 44 patients were identified in C1 gr and 44 in C3 gr. Baseline characters were well matched in both gr except, SBP (mean±SD) (C1 129.05±17.54 vs. C3 138.05±22.22, P-0.38).C1 gr (baseline to 12m): there was a S reduction in hs-CRP, A1c, BMI, SBP, DBP, TC, TG, LDL. C3 gr (baseline to 12m): there was a S reduction in hs-CRP, A1c, BMI, SBP, DBP, TC, LDL. Difference between C1 and C3 at 12m: There was no difference in hs-CRP mg/L {C1 1.88±0.43 vs. C3 1.31±0.46, p-0.371}, A1c% {C1 1.27±0.19 vs. C3 1.44±0.34, p-0.666}, BMI kg/m2 {C1 1.24±0.27 vs. C3 1.23± 0.25, p-0.988}, NT-ProBNP pg/ml {C1 63.95±65.52 vs. C3 61.53±61.71, p-0.864} eGFR {C1 6.39±3.37 vs. C3 0.99±3.20, p-0.952}, UACR mg/gm {C1 25.48±10.86 vs. C3 9.61±7.87, p-0.240}, Lipid profile, SBP and DBP between both gr.

Conclusion: Canagliflozin 100mg is as good as canagliflozin 300mg in reduction of hs-CRP and CR markers.

Disclosure

V. Gupta: None. V. Teli: None. A. Patel: None.

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