Canagliflozin Attenuates PromarkerD Diabetic Kidney Disease Risk Prediction Scores
PromarkerD is a biomarker-based blood test that predicts kidney function decline in people with type 2 diabetes (T2D) who may otherwise be missed by current standard of care tests. This study examined the association between canagliflozin and change in PromarkerD score (Δ score) over a three-year pe...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-05-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/9/3247 |
| _version_ | 1797602343111360512 |
|---|---|
| author | Kirsten E. Peters Scott D. Bringans Ronan S. O’Neill Tasha S. C. Lumbantobing James K. C. Lui Timothy M. E. Davis Michael K. Hansen Richard J. Lipscombe |
| author_facet | Kirsten E. Peters Scott D. Bringans Ronan S. O’Neill Tasha S. C. Lumbantobing James K. C. Lui Timothy M. E. Davis Michael K. Hansen Richard J. Lipscombe |
| author_sort | Kirsten E. Peters |
| collection | DOAJ |
| description | PromarkerD is a biomarker-based blood test that predicts kidney function decline in people with type 2 diabetes (T2D) who may otherwise be missed by current standard of care tests. This study examined the association between canagliflozin and change in PromarkerD score (Δ score) over a three-year period in T2D participants in the CANagliflozin cardioVascular Assessment Study (CANVAS). PromarkerD scores were measured at baseline and Year 3 in 2008 participants with preserved kidney function (baseline eGFR ≥60 mL/min/1.73 m<sup>2</sup>). Generalized estimating equations were used to assess the effect of canagliflozin versus placebo on PromarkerD scores. At baseline, the participants (mean age 62 years, 32% females) had a median PromarkerD score of 3.9%, with 67% of participants categorized as low risk, 14% as moderate risk, and 19% as high risk for kidney function decline. After accounting for the known acute drop in eGFR following canagliflozin initiation, there was a significant treatment-by-time interaction (<i>p</i> < 0.001), whereby participants on canagliflozin had decreased mean PromarkerD scores from baseline to Year 3 (Δ score: −1.0% [95% CI: −1.9%, −0.1%]; <i>p</i> = 0.039), while the scores of those on placebo increased over the three-year period (Δ score: 6.4% [4.9%, 7.8%]; <i>p <</i> 0.001). When stratified into PromarkerD risk categories, participants with high risk scores at baseline who were randomized to canagliflozin had significantly lower scores at Year 3 (Δ score: −5.6% [−8.6%, −2.5%]; <i>p</i> < 0.001), while those on placebo retained high scores (Δ score: 4.5% [0.3%, 8.8%]; <i>p</i> = 0.035). This post hoc analysis of data from CANVAS showed that canagliflozin significantly lowered PromarkerD risk scores, with the effect greatest in those T2D participants who were classified at study entry as at high risk of a subsequent decline in kidney function. |
| first_indexed | 2024-03-11T04:15:46Z |
| format | Article |
| id | doaj.art-f9722f5a02394b24aefa311751d23c25 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T04:15:46Z |
| publishDate | 2023-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-f9722f5a02394b24aefa311751d23c252023-11-17T23:12:39ZengMDPI AGJournal of Clinical Medicine2077-03832023-05-01129324710.3390/jcm12093247Canagliflozin Attenuates PromarkerD Diabetic Kidney Disease Risk Prediction ScoresKirsten E. Peters0Scott D. Bringans1Ronan S. O’Neill2Tasha S. C. Lumbantobing3James K. C. Lui4Timothy M. E. Davis5Michael K. Hansen6Richard J. Lipscombe7Proteomics International, QEII Medical Centre, 6 Verdun Street, Nedlands, WA 6009, AustraliaProteomics International, QEII Medical Centre, 6 Verdun Street, Nedlands, WA 6009, AustraliaProteomics International, QEII Medical Centre, 6 Verdun Street, Nedlands, WA 6009, AustraliaProteomics International, QEII Medical Centre, 6 Verdun Street, Nedlands, WA 6009, AustraliaProteomics International, QEII Medical Centre, 6 Verdun Street, Nedlands, WA 6009, AustraliaMedical School, The University of Western Australia, Fremantle Hospital, Fremantle, WA 6959, AustraliaJanssen Research and Development, LLC, Spring House, PA 19477, USAProteomics International, QEII Medical Centre, 6 Verdun Street, Nedlands, WA 6009, AustraliaPromarkerD is a biomarker-based blood test that predicts kidney function decline in people with type 2 diabetes (T2D) who may otherwise be missed by current standard of care tests. This study examined the association between canagliflozin and change in PromarkerD score (Δ score) over a three-year period in T2D participants in the CANagliflozin cardioVascular Assessment Study (CANVAS). PromarkerD scores were measured at baseline and Year 3 in 2008 participants with preserved kidney function (baseline eGFR ≥60 mL/min/1.73 m<sup>2</sup>). Generalized estimating equations were used to assess the effect of canagliflozin versus placebo on PromarkerD scores. At baseline, the participants (mean age 62 years, 32% females) had a median PromarkerD score of 3.9%, with 67% of participants categorized as low risk, 14% as moderate risk, and 19% as high risk for kidney function decline. After accounting for the known acute drop in eGFR following canagliflozin initiation, there was a significant treatment-by-time interaction (<i>p</i> < 0.001), whereby participants on canagliflozin had decreased mean PromarkerD scores from baseline to Year 3 (Δ score: −1.0% [95% CI: −1.9%, −0.1%]; <i>p</i> = 0.039), while the scores of those on placebo increased over the three-year period (Δ score: 6.4% [4.9%, 7.8%]; <i>p <</i> 0.001). When stratified into PromarkerD risk categories, participants with high risk scores at baseline who were randomized to canagliflozin had significantly lower scores at Year 3 (Δ score: −5.6% [−8.6%, −2.5%]; <i>p</i> < 0.001), while those on placebo retained high scores (Δ score: 4.5% [0.3%, 8.8%]; <i>p</i> = 0.035). This post hoc analysis of data from CANVAS showed that canagliflozin significantly lowered PromarkerD risk scores, with the effect greatest in those T2D participants who were classified at study entry as at high risk of a subsequent decline in kidney function.https://www.mdpi.com/2077-0383/12/9/3247type 2 diabetesdiabetic nephropathykidney declinechronic kidney diseasebiomarkersrisk prediction |
| spellingShingle | Kirsten E. Peters Scott D. Bringans Ronan S. O’Neill Tasha S. C. Lumbantobing James K. C. Lui Timothy M. E. Davis Michael K. Hansen Richard J. Lipscombe Canagliflozin Attenuates PromarkerD Diabetic Kidney Disease Risk Prediction Scores Journal of Clinical Medicine type 2 diabetes diabetic nephropathy kidney decline chronic kidney disease biomarkers risk prediction |
| title | Canagliflozin Attenuates PromarkerD Diabetic Kidney Disease Risk Prediction Scores |
| title_full | Canagliflozin Attenuates PromarkerD Diabetic Kidney Disease Risk Prediction Scores |
| title_fullStr | Canagliflozin Attenuates PromarkerD Diabetic Kidney Disease Risk Prediction Scores |
| title_full_unstemmed | Canagliflozin Attenuates PromarkerD Diabetic Kidney Disease Risk Prediction Scores |
| title_short | Canagliflozin Attenuates PromarkerD Diabetic Kidney Disease Risk Prediction Scores |
| title_sort | canagliflozin attenuates promarkerd diabetic kidney disease risk prediction scores |
| topic | type 2 diabetes diabetic nephropathy kidney decline chronic kidney disease biomarkers risk prediction |
| url | https://www.mdpi.com/2077-0383/12/9/3247 |
| work_keys_str_mv | AT kirstenepeters canagliflozinattenuatespromarkerddiabetickidneydiseaseriskpredictionscores AT scottdbringans canagliflozinattenuatespromarkerddiabetickidneydiseaseriskpredictionscores AT ronansoneill canagliflozinattenuatespromarkerddiabetickidneydiseaseriskpredictionscores AT tashasclumbantobing canagliflozinattenuatespromarkerddiabetickidneydiseaseriskpredictionscores AT jameskclui canagliflozinattenuatespromarkerddiabetickidneydiseaseriskpredictionscores AT timothymedavis canagliflozinattenuatespromarkerddiabetickidneydiseaseriskpredictionscores AT michaelkhansen canagliflozinattenuatespromarkerddiabetickidneydiseaseriskpredictionscores AT richardjlipscombe canagliflozinattenuatespromarkerddiabetickidneydiseaseriskpredictionscores |