Pérez-Belmonte, Luis M.Ricci, MicheleSanz-Cánovas, JaimeCobos-Palacios, LidiaLópez-Carmona, María D.Ruiz-Moreno, M. IsabelMillán-Gómez, MercedesBernal-López, M. RosaJansen-Chaparro, SergioGómez-Huelgas, Ricardo2022-12-202022-12-202021-05-08Pérez-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):2013http://hdl.handle.net/10668/4533Canagliflozin 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.enAtribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/De-intensificationEfficacyCanagliflozinHeart failureType 2 diabetesCapacidad de respuestaEficaciaCanagliflozinaInsuficiencia cardíacaDiabetes mellitus tipo 2HipoglucemiantesMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Hypoglycemic AgentsMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Amidines::Guanidines::Biguanides::MetforminMedical Subject Headings::Diseases::Endocrine System Diseases::Diabetes Mellitus::Diabetes Mellitus, Type 2Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Peptides::Peptide Hormones::Pancreatic Hormones::InsulinsMedical Subject Headings::Diseases::Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::HyperglycemiaMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Patient Care::HospitalizationMedical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Metals::Metals, Alkali::SodiumMedical Subject Headings::Chemicals and Drugs::Carbohydrates::Monosaccharides::Hexoses::GlucoseMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective StudiesMedical Subject Headings::Diseases::Cardiovascular Diseases::Heart Diseases::Heart FailureMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeuticsresearch article34066707open access10.3390/jcm100920132077-0383PMC8125841