{"markup":"\u003C?xml version=\u00221.0\u0022 encoding=\u0022UTF-8\u0022 ?\u003E\n    \u003Chtml version=\u0022HTML+RDFa+MathML 1.1\u0022\n    xmlns:content=\u0022http:\/\/purl.org\/rss\/1.0\/modules\/content\/\u0022\n    xmlns:dc=\u0022http:\/\/purl.org\/dc\/terms\/\u0022\n    xmlns:foaf=\u0022http:\/\/xmlns.com\/foaf\/0.1\/\u0022\n    xmlns:og=\u0022http:\/\/ogp.me\/ns#\u0022\n    xmlns:rdfs=\u0022http:\/\/www.w3.org\/2000\/01\/rdf-schema#\u0022\n    xmlns:sioc=\u0022http:\/\/rdfs.org\/sioc\/ns#\u0022\n    xmlns:sioct=\u0022http:\/\/rdfs.org\/sioc\/types#\u0022\n    xmlns:skos=\u0022http:\/\/www.w3.org\/2004\/02\/skos\/core#\u0022\n    xmlns:xsd=\u0022http:\/\/www.w3.org\/2001\/XMLSchema#\u0022\n    xmlns:mml=\u0022http:\/\/www.w3.org\/1998\/Math\/MathML\u0022\u003E\n  \u003Chead\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/js\/js_itu2PgFdrjV-docKmLK8Jn5oXe_05RgvQh73eOhI_mE.js\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_at_symbol.js?nznqs2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_article_reference_popup.js?nznqs2\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/js\/js_I8yX6RYPZb7AtMcDUA3QKDZqVkvEn35ED11_1i7vVpc.js\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022\u003E\n\u003C!--\/\/--\u003E\u003C![CDATA[\/\/\u003E\u003C!--\n(function(i,s,o,g,r,a,m){i[\u0022GoogleAnalyticsObject\u0022]=r;i[r]=i[r]||function(){(i[r].q=i[r].q||[]).push(arguments)},i[r].l=1*new Date();a=s.createElement(o),m=s.getElementsByTagName(o)[0];a.async=1;a.src=g;m.parentNode.insertBefore(a,m)})(window,document,\u0022script\u0022,\u0022\/\/www.google-analytics.com\/analytics.js\u0022,\u0022ga\u0022);ga(\u0022create\u0022, \u0022UA-15605596-27\u0022, {\u0022cookieDomain\u0022:\u0022auto\u0022});ga(\u0022set\u0022, \u0022page\u0022, location.pathname + location.search + location.hash);ga(\u0022send\u0022, \u0022pageview\u0022);ga(\u0027create\u0027, \u0027UA-189672-26\u0027, \u0027auto\u0027, {\u0027name\u0027: \u0027hwTracker\u0027});\r\nga(\u0027hwTracker.send\u0027, \u0027pageview\u0027);\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022\u003E\n\u003C!--\/\/--\u003E\u003C![CDATA[\/\/\u003E\u003C!--\njQuery.extend(Drupal.settings, {\u0022basePath\u0022:\u0022\\\/\u0022,\u0022pathPrefix\u0022:\u0022\u0022,\u0022highwire\u0022:{\u0022markup\u0022:[{\u0022requested\u0022:\u0022full-text\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;13\\\/11\\\/13\u0022},{\u0022requested\u0022:\u0022long\u0022,\u0022variant\u0022:\u0022full-text\u0022,\u0022view\u0022:\u0022full\u0022,\u0022pisa\u0022:\u0022spmdc;13\\\/11\\\/13\u0022}],\u0022ac\u0022:{\u0022spmdc;13\\\/11\\\/13\u0022:{\u0022access\u0022:{\u0022reprint\u0022:true,\u0022full\u0022:true},\u0022pisa_id\u0022:\u0022spmdc;13\\\/11\\\/13\u0022,\u0022atom_uri\u0022:\u0022\u0022,\u0022jcode\u0022:\u0022spmdc\u0022}}},\u0022googleanalytics\u0022:{\u0022trackOutbound\u0022:1,\u0022trackMailto\u0022:1,\u0022trackDownload\u0022:1,\u0022trackDownloadExtensions\u0022:\u00227z|aac|arc|arj|asf|asx|avi|bin|csv|doc(x|m)?|dot(x|m)?|exe|flv|gif|gz|gzip|hqx|jar|jpe?g|js|mp(2|3|4|e?g)|mov(ie)?|msi|msp|pdf|phps|png|ppt(x|m)?|pot(x|m)?|pps(x|m)?|ppam|sld(x|m)?|thmx|qtm?|ra(m|r)?|sea|sit|tar|tgz|torrent|txt|wav|wma|wmv|wpd|xls(x|m|b)?|xlt(x|m)|xlam|xml|z|zip\u0022,\u0022trackUrlFragments\u0022:1},\u0022ajaxPageState\u0022:{\u0022js\u0022:{\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/jquery.cluetip.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.hoverIntent.js\u0022:1,\u0022sites\\\/all\\\/libraries\\\/cluetip\\\/lib\\\/jquery.bgiframe.min.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_at_symbol.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/highwire\\\/highwire\\\/plugins\\\/highwire_markup_process\\\/js\\\/highwire_article_reference_popup.js\u0022:1,\u0022sites\\\/all\\\/modules\\\/contrib\\\/google_analytics\\\/googleanalytics.js\u0022:1,\u00220\u0022:1}}});\n\/\/--\u003E\u003C!]]\u003E\n\u003C\/script\u003E\n\u003Clink type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe sodium glucose cotransporter-2 inhibitor canagliflozin reduces HbA1C level in patients with type 2 diabetes mellitus (T2DM) and stage 3 chronic kidney disease (CKD), an effect that is more pronounced with higher levels of estimated glomerular filtration rate (eGFR), according to the results of a pooled analysis. This article presents the results of this pooled analysis of four randomized, double-blind, placebo-controlled Phase 3 trials that compared canagliflozin with placebo in patients with inadequately controlled T2DM and stage 3 CKD.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ERenal Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials Diabetes \u0026amp; Kidney Disease\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ERenal Disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes Mellitus\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Clinical Trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EEndocrinology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Kidney Disease\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThe sodium glucose cotransporter-2 inhibitor canagliflozin reduces HbA1C level in patients with type 2 diabetes mellitus (T2DM) and stage 3 chronic kidney disease (CKD), an effect that is more pronounced with higher levels of estimated glomerular filtration rate (eGFR), according to the results of a pooled analysis. Gary Meininger, MD, Janssen Research and Development LLC, Raritan, New Jersey, USA, presented the results of this pooled analysis of four randomized, double-blind, placebo-controlled Phase 3 trials that compared canagliflozin with placebo in patients with inadequately controlled T2DM and stage 3 CKD.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EOptions for glycemic control in patients with T2DM and impaired renal function are limited, said Dr. Meininger. Canagliflozin has been approved in the United States as an adjunct to diet and exercise to improve glycemic control in adults with T2DM. However, its approved dosage is limited to 100 mg QD in patients with moderate renal impairment with an eGFR \u226545 and \u0026lt;60 mL\/min\/1.73 m\u003Csup\u003E2\u003C\/sup\u003E, and it is not indicated in patients with an eGFR \u0026lt;45 mL\/min\/1.73 m\u003Csup\u003E2\u003C\/sup\u003E.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EThe present pooled analysis included 1085 patients with T2DM and stage 3 CKD (eGFR \u226530 and \u0026lt;60 mL\/min\/1.73 m\u003Csup\u003E2\u003C\/sup\u003E) who were randomized to canagliflozin 100 or 300 mg, or placebo for 18 to 26 weeks.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EIn the overall study population, the mean change from baseline to efficacy assessment in HbA1C was \u22120.52% in the canagliflozin 100-mg group; \u22120.62% in the canagliflozin 300-mg group; and \u22120.14% in the placebo group (p\u0026lt;0.001 for both canagliflozin groups vs placebo). When assessed by baseline eGFR, a greater reduction in HbA1C with canagliflozin was observed in patients with eGFR \u226545 mL\/min\/1.73 m\u003Csup\u003E2\u003C\/sup\u003E and \u0026lt;60 mL\/min\/1.73 m\u003Csup\u003E2\u003C\/sup\u003E than in those with eGFR \u226530 and \u0026lt;45 mL\/min\/1.73 m\u003Csup\u003E2\u003C\/sup\u003E.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EIn the 88.2% of all participants who were on background insulin or a sulfonylurea, the rates of documented episodes of hypoglycemia were greater with canagliflozin 100 mg and 300 mg (41.9% and 43.8%, respectively) than with placebo (29.2%).\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EWeight loss was also greater in the canagliflozin groups than in the placebo groups, and the effect was greater in patients with eGFR \u226545 mL\/min\/1.73 m\u003Csup\u003E2\u003C\/sup\u003E than in those with eGFR \u226530 and \u0026lt;45 mL\/min\/1.73 m\u003Csup\u003E2\u003C\/sup\u003E.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003ESystolic blood pressure decreased more in the overall study population in the canagliflozin groups versus the placebo group. In the subgroup with eGFR \u226530 and \u0026lt;45 mL\/min\/1.73 m\u003Csup\u003E2\u003C\/sup\u003E, systolic blood pressure increased by 0.8 mm Hg in each canagliflozin group and by 5.7 mm Hg in the placebo group.\u003C\/p\u003E\u003Cp id=\u0022p-9\u0022\u003EThe incidence of overall adverse events (AEs) was higher with canagliflozin (74.0% with 100 mg and 75.3% with 300 mg) than with placebo (70.4%). Intravascular volume-related adverse events were also more common with canagliflozin (5.0% and 8.5% in the 100- and 300-mg groups, respectively) than with placebo (2.6%). The percentage of these events in the canagliflozin groups was greater in patients with eGFR \u226530 and \u0026lt;45 mL\/min\/1.73 m\u003Csup\u003E2\u003C\/sup\u003E (6.6% and 11.1% in the 100- and 300-mg groups, respectively) relative to placebo (1.7%) than in those with eGFR \u226545 mL\/min\/1.73 m\u003Csup\u003E2\u003C\/sup\u003E (4.2% and 7.1% with 100-mg and 300-mg canagliflozin, respectively, vs 3.0% with placebo). Renal-related adverse events also occurred more frequently with canagliflozin compared with placebo, and the rates were higher in all three groups with eGFR \u226530 and \u0026lt;45 mL\/min\/1.73 m\u003Csup\u003E2\u003C\/sup\u003E.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2013 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/13\/11\/13.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nznqs2\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}