https://www.nejm.org/doi/full/10.1056/NEJMoa1811744?query=featured_home
New England Journal article. Study was stopped early because Invokana had a kidney protecting effect in the Type 2 patient population under study.
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I wonder if it would have the same effectiveness with T1…
Clearly that is a topic of interest, I am not sure of the mechanism of drug action so I wouldn’t be able to speculate. Worth speaking with you doctor about, especially if you have kidney issues as the patients in this study did.
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Isn’t this the same drug that may have higher risk of leg amputations?
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Yep, same drug. Apparently good for the kidney’s not so much for the limbs. However, if you have diabetes and kidney disease it looks like a good drug for you compared to placebo.
Sounds like they targeted those already at stage 3,4 CKD, which I agree would be more beneficial. I’ve been teetering around 60-80 eGFR the past 20 years, on altace. I didn’t see a breakdown in the results by eGFR or stage. Most doctors don’t blink an eye until stage 3 (30-60).
“There was a prespecified plan to include approximately 60% of patients with an estimated GFR of 30 to <60 ml per minute per 1.73 m2.”
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It is interesting that in this 4401 patient study there was no difference in amputation rates, although the study period was pretty short i.e. 2.6 years on average. That might be why they didn’t reproduce the Canvas-R trial results where 10,000 patients were followed for almost 3.5 years on average.
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Here are some related SGLT-2 CKD articles
T1D and I have taken invokana for about 5 years. I have all my limbs, kidney function is normal and no dka. Worse side effect is some yeast infection and dehydration. Realize some of these problems with invokana are because the patient doesn’t comply with recommendations of staying hydrated. The dka can be brought on by the no carb or low carb diets. Insulin needs some carbs otherwise you will end up with dka.
My experience is for the most part positive on this med. I found taking half of the dose to be best for me. This greatly minimizes side effects and according to my doctor the full dose does not show that it is significantly more effective than the lower dose.
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