PMID- 31198532
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231012
IS  - 2048-8505 (Print)
IS  - 2048-8513 (Electronic)
IS  - 2048-8505 (Linking)
VI  - 12
IP  - 3
DP  - 2019 Jun
TI  - Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical 
      Evaluation and Study of Diabetic Nephropathy with Atrasentan: what was learned 
      about the treatment of diabetic kidney disease with canagliflozin and atrasentan?
PG  - 313-321
LID - 10.1093/ckj/sfz070 [doi]
AB  - In April 2019, two major Phase 3 randomized clinical trials were published that 
      assessed primary renal outcomes in diabetic kidney disease (DKD) in type 2 
      diabetes mellitus (T2DM). The Canagliflozin and Renal Events in Diabetes with 
      Established Nephropathy Clinical Evaluation (CREDENCE) tested an already 
      available antidiabetic drug, canagliflozin, and the Study of Diabetic Nephropathy 
      with Atrasentan (SONAR) tested a novel molecule, the endothelin-1 receptor 
      blocker atrasentan, both on top of renin-angiotensin system blockade. Both trials 
      demonstrated significant nephroprotection in patients with overt DKD (albuminuria 
      >300 mg/g urinary creatinine) for combined primary endpoints of end-stage kidney 
      disease (ESKD), doubling of serum creatinine or death from renal or 
      cardiovascular causes in CREDENCE hazard ratio [HR] 0.70 [95% confidence 
      interval (CI) 0.59-0.82] and ESKD and doubling of serum creatinine in SONAR [HR 
      0.65 (95% CI 0.49-0.88)]. Canagliflozin also decreased the secondary renal 
      endpoint ESKD, doubling of serum creatinine or renal death [HR 0.66 (95% CI 
      0.53-0.81)], which was similar in nature and impact to the primary endpoint in 
      SONAR. In addition, canagliflozin decreased a secondary endpoint of 
      cardiovascular death or hospitalization for heart failure [HR 0.69 (95% CI 
      0.57-0.83)], whereas atrasentan had no significant impact on a secondary 
      cardiovascular composite endpoint or on hospital admissions for heart failure 
      and, despite restrictive exclusion criteria, there was a non-significant trend 
      towards more frequent episodes of heart failure. Based on these results, 
      canagliflozin will likely be approved for the indication of treating DKD in T2DM 
      and the estimated glomerular filtration rate threshold for prescribing it will be 
      lifted, whereas the future and place of atrasentan in the treatment of DKD remain 
      unclear.
FAU - Fernandez-Fernandez, Beatriz
AU  - Fernandez-Fernandez B
AD  - IIS-Fundacion Jimenez Diaz UAM and School of Medicine, UAM, Madrid, Spain.
AD  - REDINREN, Madrid, Spain.
AD  - GEENDIAB, Barcelona, Spain.
FAU - Fernandez-Prado, Raul
AU  - Fernandez-Prado R
AD  - IIS-Fundacion Jimenez Diaz UAM and School of Medicine, UAM, Madrid, Spain.
AD  - REDINREN, Madrid, Spain.
AD  - GEENDIAB, Barcelona, Spain.
FAU - Gorriz, Jose Luis
AU  - Gorriz JL
AD  - GEENDIAB, Barcelona, Spain.
AD  - Hospital Clinico Universitario, Universitat de Valencia-INCLIVA, Valencia, Spain.
FAU - Martinez-Castelao, Alberto
AU  - Martinez-Castelao A
AD  - GEENDIAB, Barcelona, Spain.
AD  - Bellvitge University Hospital, Hospitalet, Barcelona, Spain.
FAU - Navarro-Gonzalez, Juan F
AU  - Navarro-Gonzalez JF
AD  - GEENDIAB, Barcelona, Spain.
AD  - Unidad de Investigacion y Servicio de Nefrologia, Hospital Universitario Nuestra 
      Senora de Candelaria, Santa Cruz de Tenerife, Spain.
FAU - Porrini, Esteban
AU  - Porrini E
AD  - GEENDIAB, Barcelona, Spain.
AD  - Instituto de Tecnologias Biomedicas, Hospital Universitario de Canarias, 
      Universidad de La Laguna, Santa Cruz de Tenerife, Spain.
FAU - Soler, Maria Jose
AU  - Soler MJ
AD  - GEENDIAB, Barcelona, Spain.
AD  - Nephrology Department, Hospital Universitari Vall d'Hebron, Universitat Autonoma 
      de Barcelona, Barcelona, Spain.
AD  - Nephrology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain.
FAU - Ortiz, Alberto
AU  - Ortiz A
AD  - IIS-Fundacion Jimenez Diaz UAM and School of Medicine, UAM, Madrid, Spain.
AD  - REDINREN, Madrid, Spain.
AD  - GEENDIAB, Barcelona, Spain.
LA  - eng
PT  - Journal Article
DEP - 20190531
PL  - England
TA  - Clin Kidney J
JT  - Clinical kidney journal
JID - 101579321
PMC - PMC6543971
OTO - NOTNLM
OT  - albuminuria
OT  - atrasentan
OT  - canagliflozin
OT  - chronic kidney disease
OT  - diabetic kidney disease
OT  - endothelin
OT  - sodium-glucose cotransporter-2 (SGLT2) inhibitor
EDAT- 2019/06/15 06:00
MHDA- 2019/06/15 06:01
PMCR- 2019/05/31
CRDT- 2019/06/15 06:00
PHST- 2019/05/08 00:00 [received]
PHST- 2019/06/15 06:00 [entrez]
PHST- 2019/06/15 06:00 [pubmed]
PHST- 2019/06/15 06:01 [medline]
PHST- 2019/05/31 00:00 [pmc-release]
AID - sfz070 [pii]
AID - 10.1093/ckj/sfz070 [doi]
PST - epublish
SO  - Clin Kidney J. 2019 May 31;12(3):313-321. doi: 10.1093/ckj/sfz070. eCollection 
      2019 Jun.