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Researchers have discovered that the diabetes drug has heart and kidneys



The study was funded by the pharmaceutical company Janssen, manufacturer of the drug Canagliflozin, which carries the brand name Invokana. In March, the company's US Food and Drug Administration (Canadliflozin) submitted a supplemental new drug application to help reduce the risk of end-stage renal disease and renal or cardiovascular death in adults with type 2 diabetes and to reduce chronic kidney disease.

The study included 4,401 patients, ages 30 and older, with type 2 diabetes and chronic kidney disease. These patients were randomized to take either canagliflozin or a placebo at 690 locations in 34 countries from March 2014 to May 2017.

They were monitored at 3, 13 and 26 weeks, during which the effects of the drug appeared to be monitored.

The researchers found that in the canagliflozin group the renal relative risk of death was 34% lower and the relative risk of end-stage renal disease was 32% lower. The group also had a lower risk of cardiovascular death, myocardial infarction, stroke and hospitalization for heart failure.

Based on data in the study, the researchers estimated that treatment with canagliflozin 22 would prevent hospital admissions for heart failure and 25 composite events of cardiovascular disease death, heart attack or stroke in 1

,000 patients.

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Regarding harmful results, it was found that canagliflozin increased the risk as a side effect of an amputation However, the researchers did not see any significant difference in the risk of lower limb amputation between the two groups in the study. The bone fracture rate, another known side effect of canagliflozin, was similar in both groups, according to the study.
The study also showed that the risk of diabetic ketoacidosis is a life-threatening problem when the body starts to lose fat at an unhealthy fast rate it was low overall but higher in the canagliflozin group.

The study had some limitations, including that patients who had a very advanced kidney disease were not included. Patients believed to be affected by kidney disease other than type 2 diabetes were also excluded. To determine if the study's results could be generalized to other types of kidney disease, more research is needed.

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This study has that Potential to influence medical practice However, Mark Molitch, professor of endocrinology at Northwestern University's Feinberg School of Medicine, who was not involved in the new study, has often prescribed canagliflozin for his own patients.
Canagliflozin, a drug for the treatment of type 2 diabetes, belongs to a class of drugs called sodium-glucose cotransporter-2 or SGLT2 inhibitors. Remove sugar from the body through urine.

"With this whole class of medications, we really need to think about how we use it, because of the cardio-renal benefits," says Molitch id about SGLT2 inhibitors.

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"This class of drugs really affects the kidney from a diabetes perspective. Usually we have a lot of glucose – the main sugar that circulates in the blood – and then the kidney filters that glucose. That's why most of the time there is no glucose in the urine, because the kidney reabsorbs all the glucose that is filtered out of the blood, "he said. "What these medications do is they hold back this reabsorption of glucose from the urine into the blood, and so you excrete lots of glucose into the urine."

That added Molitch, a member of the Endocrine Society The benefits to the heart and kidney described in the new study are "surpassing the benefits of a mere blood sugar lowering."

"We still are not entirely sure what mechanisms cause these heart and kidney effects, but they are clearly not just because of lowering blood sugar levels," he said.

"The benefit to the heart and kidney occurs in patients with advanced kidney disease who have a minimal effect on the blood sugar lowering effect of canagliflozin," he said. "Based on this study, we could only use canagliflozin for kidney and possibly cardiac benefits, while keeping other glucose levels under control in patients with diabetes and kidney disease."

The effect of the drug was quite dr. Derek Leroith, Professor of Medicine and Interim Chief of the Department of Endocrinology, Diabetes and Bone Diseases of Hilda & J. Lester at the Icahn School of Medicine at Mount Sinai in New York, said in the study in an e-mail. Leroith is also a chair of diabetes guidelines for the Endocrine Society.

"This study was conceived for people with diabetic kidney disease and is thus the first example of a reduction in the risk of renal failure [as] and improved cardiovascular outcomes," said Leroith, who was not involved in the study. "I believe that the paper is of great importance and will have a broad readership with a big impact."


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