CoChat
Sign Up
Cited by 135Erythropoietin and Anemia TreatmentDiabetes Treatment and ManagementChronic Kidney Disease and Diabetes

The DOI matches its Crossref record; 30 of the 30 references it cites were found in a registry or an index.

Effects of canagliflozin on anaemia in patients with type 2 diabetes and chronic kidney disease: a post-hoc analysis from the CREDENCE trial

Open access
Oshima, Megumi, Neuen, Brendon L, Jardine, Meg J, Bakris, George, Edwards, Robert, Levin, Adeera, Mahaffey, Kenneth W, Neal, Bruce, Pollock, Carol, Rosenthal, Norman, Wada, Takashi, Wheeler, David C, Perkovic, Vlado, Heerspink, Hiddo J L·2020·The Lancet Diabetes & Endocrinology
DOI 10.1016/s2213-8587(20)30300-4
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Sodium-glucose co-transporter 2 inhibitors might enhance erythropoiesis and increase red blood cell mass. We assessed the long-term effects of canagliflozin on anaemia-related outcomes. METHODS: In a post-hoc analysis of the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial, we included patients with type 2 diabetes and chronic kidney disease who were randomly assigned to treatment with canagliflozin or placebo at 690 sites in 34 countries. We assessed the effects of canagliflozin versus matched placebo on haemoglobin and haematocrit using linear mixed-effects models. The primary outcome of this post-hoc analysis was a composite outcome of investigator-reported anaemia or treatment for anaemia, which was assessed using Kaplan-Meier analysis and Cox regression models. All analyses were done by intention to treat. FINDINGS: Between March 24, 2014, and May 5, 2017, 4401 participants were randomly assigned to receive canagliflozin (100 mg; n=2202) or placebo (n=2199). At baseline, mean haemoglobin concentration was 132·0 g/L (SD 17·7), 1599 (36%) of 4401 participants had anaemia (defined as haemoglobin <130 g/L in men or <120 g/L in women), and 33 (<1%) of 4401 participants used erythropoiesis-stimulating agents. During a median follow-up period of 2·6 years (IQR 2·1-3·1), mean haemoglobin concentration was 7·1 g/L (95% CI 6·4-7·8) higher and haematocrit was 2·4% (2·2-2·6) higher in the canagliflozin group than the placebo group. Overall, 573 of 4401 participants had either an investigator-reported anaemia event or initiation of treatment for anaemia: 358 (8%) of 4401 participants reported anaemia events, 343 (8%) initiated iron preparations, 141 (3%) initiated erythropoiesis-stimulating agents, and 114 (2%) received blood transfusion. The risk of the composite outcome of anaemia events or initiation of treatment for anaemia was lower in the canagliflozin group than the placebo group (hazard ratio 0·65, 95% CI 0·55-0·77; p<0·0001). Compared with the placebo group, participants in the canagliflozin group also had lower risks of anaemia events alone (0·58, 0·47-0·72; p<0·0001), initiation of iron preparations (0·64, 0·52-0·80; p<0·0001), and need for erythropoiesis-stimulating agents (0·65, 0·46-0·91; p=0·012). INTERPRETATION: These data suggest that canagliflozin reduces the risk of anaemia-associated outcomes, including the need for erythropoiesis-stimulating agents, among patients with type 2 diabetes and chronic kidney disease. FUNDING: Janssen Research and Development.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1016/s2213-8587(20)30300-4

Cites

30 of 30 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Cited by

Sorted by citations

See all 135

Related

See all

Metadata

Authors
Oshima, M., Neuen, B. L., Jardine, M. J., Bakris, G., Edwards, R., Levin, A., Mahaffey, K. W., Neal, B., Pollock, C., Rosenthal, N., Wada, T., Wheeler, D. C., Perkovic, V., & Heerspink, H. J. L.
Affiliations
  • Kanazawa University (JP)
  • UNSW Sydney (AU)
  • Concord Repatriation General Hospital (AU)
  • University of Chicago (US)
  • Janssen Research & Development (United States) (US)
  • University of British Columbia (CA)
  • Stanford Medicine (US)
  • The University of Sydney (AU)
  • The George Institute for Global Health (GB)
  • Royal North Shore Hospital (AU)
  • University Medical Center Groningen (NL)
Corresponding author
Heerspink, Hiddo J L
ORCID
Venue
The Lancet Diabetes & Endocrinology
Publisher
Elsevier BV
Published
2020-11
Volume
8
Issue
11
Pages
903-914
ISSN
2213-8587 (ISSN-L)
DOI
10.1016/s2213-8587(20)30300-4
OpenAlex
W3093341334
Cited by
135
References
30
Citations by year
2026: 15 · 2025: 17 · 2024: 26 · 2023: 28 · 2022: 20 · 2021: 29
FWCI
12.16
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Diabetes & Endocrinology (publishedVersion, public-domain)
  • PubMed (publishedVersion)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
  • UCL Discovery (University College London) (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
  • Spiral (Imperial College London) (submittedVersion, cc-by-nc-nd)
Funders
  • Janssen Research and Development
  • Janssen Scientific Affairs
  • National Health and Medical Research Council
  • University of New South Wales
  • Nederlandse Organisatie voor Wetenschappelijk Onderzoek
Topics
  • Health Sciences › Medicine › Hematology › Erythropoietin and Anemia Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
  • Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords
canagliflozin, anemia, type 2 diabetes, chronic kidney disease, SGLT2 inhibitors, hemoglobin, hematocrit, erythropoiesis, iron supplementation, erythropoiesis-stimulating agents, CREDENCE trial, renal outcomes, haemoglobin decline, iron deficiency, iron overload
MeSH terms
Canagliflozin, Sodium-Glucose Transporter 2 Inhibitors, Aged, Anemia, Diabetes Mellitus, Type 2, Double-Blind Method, Female, Follow-Up Studies, Humans, Male, Middle Aged, Treatment Outcome, Renal Insufficiency, Chronic

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review