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Rationale and design of a randomized trial to test the safety and non-inferiority of canagliflozin in patients with diabetes with chronic heart failure: the CANDLE trial

Overview of attention for article published in Cardiovascular Diabetology, April 2016
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Title
Rationale and design of a randomized trial to test the safety and non-inferiority of canagliflozin in patients with diabetes with chronic heart failure: the CANDLE trial
Published in
Cardiovascular Diabetology, April 2016
DOI 10.1186/s12933-016-0381-x
Pubmed ID
Authors

Atsushi Tanaka, Teruo Inoue, Masafumi Kitakaze, Jun-ichi Oyama, Masataka Sata, Isao Taguchi, Wataru Shimizu, Hirotaka Watada, Hirofumi Tomiyama, Junya Ako, Yasushi Sakata, Toshihisa Anzai, Masaaki Uematsu, Makoto Suzuki, Kazuo Eguchi, Akira Yamashina, Yoshihiko Saito, Yasunori Sato, Shinichiro Ueda, Toyoaki Murohara, Koichi Node

Abstract

Because type 2 diabetes mellitus is associated strongly with an increased risk of cardiovascular diseases, the number of patients with diabetes with chronic heart failure is increasing steadily. However, clinical evidence of therapeutic strategies in such patients is still lacking. A recent randomized, placebo-controlled trial in patients with type 2 diabetes with high cardiovascular risk demonstrated that the SGLT2 inhibitor, empagliflozin, reduced the incidence of hospitalization for heart failure. Because SGLT2 inhibitors cause a reduction in body weight and blood pressure in addition to improving glycemic control, they have the potential to exert beneficial effects on the clinical pathophysiology of heart failure. The aim of the ongoing CANDLE trial is to test the safety and non-inferiority of canagliflozin, another SGLT2 inhibitor, compared with glimepiride, a sulfonylurea agent, in patients with type 2 diabetes mellitus and chronic heart failure. A total of 250 patients with type 2 diabetes who are drug-naïve or taking any anti-diabetic agents and suffering from chronic heart failure with a New York Heart Association classification I to III will be randomized centrally into either canagliflozin or glimepiride groups (1: 1) using the dynamic allocation method stratified by age (<65, ≥65 year), HbA1c level (<6.5, ≥6.5 %), and left ventricular ejection fraction (<40, ≥40 %). After randomization, all the participants will be given the add-on study drug for 24 weeks in addition to their background therapy. The primary endpoint is the percentage change from baseline in NT-proBNP after 24 weeks of treatment. The key secondary endpoints after 24 weeks of treatment are the change from baseline in glycemic control, blood pressure, body weight, lipid profile, quality of life score related to heart failure, and cardiac and renal function. The CANDLE trial is the first to assess the safety and non-inferiority of canagliflozin in comparison with glimepiride in patients with type 2 diabetes with chronic heart failure. This trial has the potential to evaluate the clinical safety and efficacy of canagliflozin on heart failure. Trial registration Unique trial Number, UMIN000017669.

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Mendeley readers

The data shown below were compiled from readership statistics for 191 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 191 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 25 13%
Other 22 12%
Student > Master 16 8%
Researcher 15 8%
Student > Ph. D. Student 15 8%
Other 34 18%
Unknown 64 34%
Readers by discipline Count As %
Medicine and Dentistry 80 42%
Pharmacology, Toxicology and Pharmaceutical Science 13 7%
Nursing and Health Professions 10 5%
Biochemistry, Genetics and Molecular Biology 6 3%
Agricultural and Biological Sciences 4 2%
Other 11 6%
Unknown 67 35%