Summary

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• This summary is based on the review of 85 systematic review(s)/meta-analysis(es). ^[1-85]
• Canagliflozin demonstrated significant effectiveness in reducing renal outcomes, with benefits observed even in patients with severe chronic kidney disease (CKD) (estimated glomerular filtration rate (eGFR) < 45 mL/min/1.73 m²) and consistent effects across varying baseline eGFR levels.
• In high-risk cardiovascular populations, canagliflozin reduced the risk of major adverse cardiovascular events (MACE) and hospitalization for heart failure, with notable efficacy in elderly patients, including those over 65 years of age.
• Canagliflozin showed significant cardiovascular benefits in Hispanic patients, with no heterogeneity observed by baseline eGFR, supporting its use across diverse demographic groups.
• The cardiovascular and renal benefits of canagliflozin were consistent across various subgroups, including those with differing albuminuria levels and concurrent use of renin-angiotensin system (RAS) blockade.
• Canagliflozin was associated with a significantly higher risk of diabetic ketoacidosis (DKA) and showed increased risks of genital infections and urinary tract infections compared to other sodium glucose co-transporter 2 (SGLT2) inhibitors.
• In the Canagliflozin Cardiovascular Assessment Study (CANVAS), canagliflozin presented a significant increase in the risk of lower limb amputations, with a hazard ratio of 1.60 (95% confidence interval (CI) 1.04-2.46).
• While some studies indicated an increased risk of fractures with canagliflozin, this finding was not consistently observed across all studies.
• Canagliflozin did not show a significant increase in the risk of acute kidney injury (AKI) and was associated with a protective effect against AKI, indicating a favorable safety profile in this regard.
• Canagliflozin was effective in reducing renal outcomes, even in patients with severe chronic kidney disease (eGFR < 45 mL/min/1.73 m²), with consistent benefits observed across varying baseline eGFR levels.
• In patients at high cardiovascular risk, canagliflozin significantly reduced the risk of MACE and heart failure hospitalization, demonstrating its cardiovascular benefits in this population.