RT Journal Article
T1 De-Intensification of Antidiabetic Treatment Using Canagliflozin in Patients with Heart Failure and Type 2 Diabetes: Cana-Switch-HF Study
A1 Pérez-Belmonte, Luis M.
A1 Ricci, Michele
A1 Sanz-Cánovas, Jaime
A1 Cobos-Palacios, Lidia
A1 López-Carmona, María D.
A1 Ruiz-Moreno, M. Isabel
A1 Millán-Gómez, Mercedes
A1 Bernal-López, M. Rosa
A1 Jansen-Chaparro, Sergio
A1 Gómez-Huelgas, Ricardo
K1 De-intensification
K1 Efficacy
K1 Canagliflozin
K1 Heart failure
K1 Type 2 diabetes
K1 Capacidad de respuesta
K1 Eficacia
K1 Canagliflozina
K1 Insuficiencia cardíaca
K1 Diabetes mellitus tipo 2
K1 Hipoglucemiantes
AB Canagliflozin is a sodium-glucose co-transporter 2 inhibitor that reduces glycemia as well as the risk of cardiovascular events. Our main objective was to analyze antidiabetic treatment de-intensification and the glycemic efficacy of replacing antidiabetic agents (excluding metformin) with canagliflozin in patients with heart failure and type 2 diabetes with poor glycemic control. In this observational, retrospective, real-world study, we selected patients treated with metformin in combination with ≥2 non-insulin antidiabetic agents or metformin in combination with basal insulin plus ≥1 non-insulin antidiabetic agent. Non-insulin antidiabetic agents were replaced with canagliflozin. Patients were followed-up on at three, six, and 12 months after the switch and a wide range of clinical variables were recorded. A total of 121 patients were included. From baseline to 12 months, the number of antidiabetic agents (3.1 ± 1.0 vs. 2.1 ± 0.8, p < 0.05), basal insulin dose (20.1 ± 9.8 vs. 10.1 ± 6.5 units, p < 0.01), and percentage of patients who used basal insulin (47.9% vs. 31.3%, p < 0.01) decreased. The proportion of patients who used diuretics also declined significantly. In addition, we observed improvement in glycemic control, with an increase in the proportion of patients with glycated hemoglobin <7% from 16.8% at three months to 63.5% at 12 (p < 0.001). Canagliflozin use was also beneficial in terms of body weight, blood pressure, heart failure status, functional class, and cardiovascular-renal risk. There were also reductions in the number of emergency department visits and hospitalizations for heart failure. Moreover, canagliflozin was well-tolerated, with a low rate of drug-related discontinuation. Mounting evidence from randomized controlled trials and real-world studies point to the beneficial profile of sodium-glucose co-transporter type 2 inhibitors such as canagliflozin in patients with heart failure.
PB MDPI
YR 2021
FD 2021-05-08
LK http://hdl.handle.net/10668/4533
UL http://hdl.handle.net/10668/4533
LA en
NO Pérez-Belmonte LM, Ricci M, Sanz-Cánovas J, Cobos-Palacios L, López-Carmona MD, Ruiz-Moreno MI, et al. De-Intensification of Antidiabetic Treatment Using Canagliflozin in Patients with Heart Failure and Type 2 Diabetes: Cana-Switch-HF Study. J Clin Med. 2021 May 8;10(9):2013
DS RISalud
RD Jul 29, 2025