Canagliflozin reduces onset of cardiac failure compared to other anti-diabetic drugs


Adapted from BMJ 10 Feb 18

A large population based cohort study showed that patients who started canagliflozin had a markedly reduced risk of being admitted to hospital with cardiac failure compared to three other types of anti-diabetes drugs.  There was no increase in heart attacks or stroke.

The study was based in the USA and the comparative drugs were DPP-4 inhibitors such as Victoza and Byetta, Gliptans such as Linagliptan and Sitagliptan, and sulphonylureas such as Gliclazide.   There was a 30-49% decrease in hospitalisations for cardiac failure.

None of the patients had a history of cardiac failure or cardiovascular disease at the start of the study and the patients were compared to others with the same HbA1C to ensure a fair comparison.

The reduction in cardiac failure could be a class effect of the Flozin drugs but further studies would be needed to find out. No other Flozins were used in the study as comparators.

Between 17,354 and 20,539 pairs of patients were matched for each comparison making this a very large study indeed.

2 thoughts on “Canagliflozin reduces onset of cardiac failure compared to other anti-diabetic drugs”

  1. I read about this study and I think the design is lacking in a few ways.

    1. This is not a study of people who had heart attacks, rather people admitted for them. It seems to me it would be more powerful to look at people who had heart attacks and compare the sub populations of Type 2 users.

    2. In the US at least more people are not users because of the cost of these medications, it may not be a factor in the UK, but it certainly is in the US.

    3. We have no way of knowing the previous heart history of the population. I mean are people put on the medication if they have previous heart attacks? Were they on other medications before they were place on this one?

    I just know that association is not causation, so color me skeptical. Ont he other hand it is incredibility interesting.


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