Diabetes Mellitus, Type 2Phase 4CANVAS-RNCT01989754
A Study of the Effects of Canagliflozin (JNJ-28431754) on Renal Endpoints in Adult Participants With Type 2 Diabetes Mellitus
A Phase 4 study testing Canagliflozin, 100 mg and Canagliflozin, 300 mg in people with Diabetes Mellitus, Type 2 and Albuminuria, run by Janssen Research & Development, LLC at 341 sites in 25 countries.
Trial summary
The purpose of this study is to assess the effect of canagliflozin compared to placebo on progression of albuminuria in participants with Type 2 Diabetes Mellitus receiving standard care but with inadequate glycemic control and at elevated risk of cardiovascular events. Read more about this study
- Who is it for?
- Ages 30 years and older
- Conditions the study is for
- Diabetes Mellitus, Type 2, Albuminuria
- What is being tested?
- Canagliflozin, 100 mg and Canagliflozin, 300 mg
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 5,813 participants
- Where
- 341 sitesin 25 countries
- Study dates
- 16 Jan 2014to 23 Feb 2017
- Phase
- Phase 4
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 30 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Must have a diagnosis of type 2 diabetes mellitus
- Must have inadequate diabetes control (as defined by glycosylated hemoglobin level >=7.0% to <=10.5% at screening)
- Greater than or equal to (>=) 30 yrs old with history of cardiovascular (CV) event, or >= 50 yrs old with high risk of CV events
- Must be either not on antihyperglycemic agents (AHA) therapy, or on AHA monotherapy, or combination AHA therapy with any approved agent for the control of blood glucose levels.
Who cannot join
- History of diabetic ketoacidosis, type 1 diabetes mellitus, pancreas or beta-cell transplantation, or diabetes secondary to pancreatitis or pancreatectomy
- History of one or more severe hypoglycemic episode within 6 months before screening
- History of hereditary glucose-galactose malabsorption or primary renal glucosuria
- Ongoing, inadequately controlled thyroid disorder
- Renal disease that required treatment with immunosuppressive therapy or a history of chronic dialysis or renal transplant
- Myocardial infarction, unstable angina, revascularization procedure, or cerebrovascular accident within 3 months before screening.
Trial locations and contacts
341 sites in 25 countries.
341 sites in 25 countries
United States57 sites
Study site
Austin, Texas
Study site
Beaver, Pennsylvania
Study site
Bountiful, Utah
Study site
Canal Fulton, Ohio
Study site
Carmichael, California
Study site
Chicago, Illinois
Study site
Concord, California
Study site
Cornelius, North Carolina
Study site
Denver, Colorado
Study site
Draper, Utah
Study site
Elkridge, Maryland
Study site
Falls Church, Virginia
Study site
Flint, Michigan
Study site
Franklin, Ohio
Study site
Greer, South Carolina
Study site
Hickory, North Carolina
Study site
Hollywood, Florida
Study site
Jacksonville, Florida
Study site
Jefferson City, Tennessee
Study site
Kansas City, Missouri
Study site
Las Vegas, Nevada
Study site
Levittown, Pennsylvania
Study site
Little Rock, Arkansas
Study site
Louisville, Kentucky
Study site
Mandeville, Louisiana
Study site
Mason, Ohio
Study site
Meridian, Idaho
Study site
Metairie, Louisiana
Study site
Miami, Florida
Study site
Milwaukee, Wisconsin
Study site
Mooresville, North Carolina
Study site
New Port Richey, Florida
Study site
Norfolk, Virginia
Study site
Norristown, Pennsylvania
Study site
Oklahoma City, Oklahoma
Study site
Omaha, Nebraska
Study site
Opa-locka, Florida
Study site
Orlando, Florida
Study site
Palm Harbor, Florida
Study site
Pearland, Texas
Study site
Picayune, Mississippi
Study site
Pismo Beach, California
Study site
Pittsburgh, Pennsylvania
Study site
Roseville, California
Study site
Salt Lake City, Utah
Study site
South Burlington, Vermont
Study site
Spokane, Washington
Study site
St Louis, Missouri
Study site
Tampa, Florida
Study site
Thousand Oaks, California
Study site
Tipton, Pennsylvania
Study site
Topeka, Kansas
Study site
Valparaiso, Indiana
Study site
Virginia Beach, Virginia
Study site
Washington, Missouri
Study site
Wauwatosa, Wisconsin
Study site
West Jordan, Utah
Spain24 sites
Study site
A Coruña
Study site
Alcalá de Henares
Study site
Alicante
Study site
Almería
Study site
Alzira
Study site
Barcelona
Study site
Ciudad Real
Study site
Córdoba
Study site
Ferrol
Study site
Figueres
Study site
Galdakao
Study site
Madrid
Study site
Málaga
Study site
Móstoles
Study site
Palma de Mallorca
Study site
Sabadell
Study site
San Sebastián de los Reyes
Study site
Sant Joan d'Alacant
Study site
Santa Cruz de Tenerife
Study site
Santiago de Compostela
Study site
Segovia
Study site
Seville
Study site
Valencia
Study site
Viladecans
Netherlands21 sites
Study site
Almelo
Study site
Almere Stad
Study site
Amersfoort
Study site
Amsterdam
Study site
Dordrecht
Study site
Eindhoven
Study site
Groningen
Study site
Hardenberg
Study site
Hoogeveen
Study site
Hoogezand
Study site
Kloosterhaar
Study site
Leiden
Study site
Meppel
Study site
Poortvliet
Study site
Rotterdam
Study site
Utrecht
Study site
Velp
Study site
Waalwijk
Study site
Wamel
Study site
Zoetermeer
Study site
Zwijndrecht
United Kingdom19 sites
Study site
Addlestone
Study site
Belfast
Study site
Birmingham
Study site
Blackburn
Study site
Bristol
Study site
Bury St Edmunds
Study site
Chesterfield
Study site
Derby
Study site
Doncaster
Study site
Ipswich
Study site
Leicester
Study site
Liverpool
Study site
Manchester
Study site
Salford
Study site
Taunton
Study site
Torquay
Study site
Truro
Study site
Wellingborough
Study site
Welwyn Garden City
Ukraine17 sites
Study site
Cherkasy
Study site
Chernivtsy
Study site
Dnipropetrovsk
Study site
Ivan-Frankivsk
Study site
Ivano-Frankivsk
Study site
Kharkiv
Study site
Kiev
Study site
Kyiv
Study site
Lviv
Study site
Odesa
Study site
Poltava
Study site
Sumy
Study site
Ternopil
Study site
Uzhhorod
Study site
Vinnitsa
Study site
Vinnytsia
Study site
Zaporizhzhya
Canada16 sites
Study site
Coquitlam, British Columbia
Study site
Guelph, Ontario
Study site
Halifax, Nova Scotia
Study site
Laval, Quebec
Study site
Lévis, Quebec
Study site
Mississauga, Ontario
Study site
Oshawa, Ontario
Study site
Québec, Quebec
Study site
Saint Marc Des Carriéres, Quebec
Study site
Sarnia, Ontario
Study site
Saskatoon, Saskatchewan
Study site
Sherbrooke, Quebec
Study site
Thornhill, Ontario
Study site
Toronto, Ontario
Study site
Westmont, Quebec
Study site
Winnipeg, Manitoba
Russia15 sites
Study site
Arkhangelsk
Study site
Barnaul
Study site
Chelyabinsk
Study site
Kemerovo
Study site
Nizhny Novgorod
Study site
Penza
Study site
Rostov-on-Don
Study site
Saint Petersburg
Study site
Samara
Study site
Saratov
Study site
Smolensk
Study site
Syktyvkar
Study site
Tyumen
Study site
Vsevolzhsk
Study site
Yaroslavl
South Korea15 sites
Study site
Ansan
Study site
Bucheon-si
Study site
Busan
Study site
Changwon
Study site
Cheongju-si
Study site
Daegu
Study site
Gyeonggi-do
Study site
Iksan
Study site
Incheon
Study site
Jeonju
Study site
Seongnam-si
Study site
Seoul
Study site
Suwon
Study site
Ulsan
Study site
Wŏnju
Italy13 sites
Study site
*Osenza*
Study site
Arenzano
Study site
Bologna
Study site
Catanzaro
Study site
Chieri (Torino)
Study site
Florence
Study site
Messina
Study site
Milan
Study site
Naples
Study site
Ravenna
Study site
Roma
Study site
Sesto San Giovanni (Milano)
Study site
Verona
Poland13 sites
Study site
Bialystok
Study site
Bydgoszcz
Study site
Chrzanów
Study site
Gdansk
Study site
Grodzisk Mazowiecki
Study site
Katowice
Study site
Krakow
Study site
Lublin
Study site
Oświęcim
Study site
Torun
Study site
Tychy
Study site
Warsaw
Study site
Wroclaw
Australia12 sites
Study site
Box Hill
Study site
Cairns
Study site
Daw Park
Study site
Freemantle
Study site
Liverpool
Study site
Melbourne
Study site
Newcastle
Study site
Sherwood
Study site
Sydney
Study site
Tasmania
Study site
Woden
Study site
Woolloongabba
Belgium12 sites
Study site
Bonheiden
Study site
Bruges
Study site
Edegem
Study site
Ghent
Study site
La Louvière
Study site
Leuven
Study site
Liège
Study site
Liÿge
Study site
Merksem
Study site
Ransart
Study site
Roeselare
Study site
Tessenderlo
Brazil12 sites
Study site
Belém
Study site
Belo Horizonte
Study site
Campinas
Study site
Caxias do Sul
Study site
Curitiba
Study site
Fortaleza
Study site
Mogi das Cruzes
Study site
Passo Fundo
Study site
Porto Alegre
Study site
Rio de Janeiro
Study site
São José do Rio Preto
Study site
São Paulo
Germany12 sites
Study site
Aschaffenburg
Study site
Aßlar
Study site
Bad Oeynhausen
Study site
Dortmund
Study site
Dresden
Study site
Freiburg im Breisgau
Study site
Hanover
Study site
Kassel
Study site
Mainz
Study site
Neuwied
Study site
Saarbrücken
Study site
Villingen-Schwenningen
Sweden12 sites
Study site
Borås
Study site
Gothenburg
Study site
Helsingborg
Study site
Karlstad
Study site
Linköping
Study site
Lund
Study site
Malmö
Study site
Stockholm
Study site
Uddevalla
Study site
Uppsala
Study site
Vällingby
Study site
Västra Frölunda
Hungary11 sites
Study site
Balatonfüred
Study site
Budapest
Study site
Dunaújváros
Study site
Eger
Study site
Kecskemét
Study site
Nagykanizsa
Study site
Pécs
Study site
Székesfehérvár
Study site
Szikszó
Study site
Szombathely
Study site
Zalaegerszeg
France10 sites
Study site
Amiens
Study site
Bois-Guillaume
Study site
Bordeaux
Study site
Dijon
Study site
Grenoble
Study site
La Rochelle
Study site
Le Creusot
Study site
Narbonne
Study site
Paris
Study site
Poitiers
Mexico10 sites
Study site
Aguascalientes
Study site
Celaya
Study site
Cuernavaca
Study site
Culiacán
Study site
Guadalajara
Study site
México
Study site
Pachuca
Study site
Querétaro
Study site
San Luis Potosí City
Study site
Tampico
Argentina7 sites
Study site
Buenos Aires
Study site
Ciudad de Buenos Aires
Study site
Córdoba
Study site
Mar del Plata
Study site
Morón
Study site
Rosario
Study site
Zarate, Buenos Aires
Malaysia7 sites
Study site
Batu Caves
Study site
George Town
Study site
Ipoh
Study site
Kelantan
Study site
Kota Bharu
Study site
Kuala Lumpur
Study site
Kuching
New Zealand7 sites
Study site
Auckland
Study site
Christchurch
Study site
Newtown
Study site
Palmerston North
Study site
Rotorua
Study site
Tauranga
Study site
Wellington
China6 sites
Study site
Baotou
Study site
Beijing
Study site
Hangzhou
Study site
Jinan
Study site
Shenyang
Study site
Wuxi
Taiwan6 sites
Study site
Kaohsiung County
Study site
Taichung
Study site
Tainan
Study site
Taipei
Study site
Tiachung
Study site
Xindian
Czechia5 sites
Study site
Beroun
Study site
Ostrava
Study site
Pilsen
Study site
Prague
Study site
Znojmo
About this study
Official title: A Randomized, Multicenter, Double-Blind, Parallel, Placebo-Controlled Study of the Effects of Canagliflozin on Renal Endpoints in Adult Subjects With Type 2 Diabetes Mellitus
The purpose of this study is to assess the effect of canagliflozin compared to placebo on progression of albuminuria in participants with Type 2 Diabetes Mellitus receiving standard care but with inadequate glycemic control and at elevated risk of cardiovascular events.
Read the detailed description
The study will be conducted in adult participants with Type 2 Diabetes Mellitus (T2DM), receiving standard of care for hyperglycemia and cardiovascular (CV) risk factors, who have either a history of a prior CV event or 2 or more risk factors for a CV event. Participants will be randomly assigned in a 1:1 ratio to canagliflozin or matching placebo to be taken once daily. Canagliflozin will be provided at a dose of 100 mg/day through Week 13 and then increased at the discretion of the investigator to a dose of 300 mg/day, if the participant requires additional glycemic control and is tolerating the 100 mg dose.
The study consists of a 2-week screening period and a double-blind treatment period lasting between 78 and 156 weeks; study completion is targeted for when the last subject randomized has approximately 78 weeks of follow-up or when 688 major adverse cardiovascular events are accumulated between CANVAS and CANVAS-R. A total of 5,700 participants are targeted to be recruited into the study. Participants can be either drug naïve to antihyperglycemic agents, using monotherapy, or using combination of antihyperglycemic therapy for the control of blood glucose levels.
The completion target was reached in February 2017.
- Conditions
- Diabetes Mellitus, Type 2, Albuminuria
- Being tested
- Placebo, Canagliflozin, 100 mg, Canagliflozin, 300 mg
- Keywords
- Albuminuria, Canagliflozin, Cardiovascular outcomes, Type 2 Diabetes Mellitus, T2DM, JNJ-28431754, Antihyperglycemic Agent
- Medical subject headings
- Diabetes Mellitus, Type 2, Albuminuria
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PlaceboDrug
One placebo capsule taken orally (by mouth) once daily for 156 weeks
Canagliflozin, 100 mgDrug
One 100 mg capsule taken orally (by mouth) once daily
Canagliflozin, 300 mgDrug
One 300 mg capsule taken orally (by mouth) once daily
| Study group | Role | What they receive |
|---|---|---|
| Canagliflozin (JNJ-28431754) | Experimental | Each patient will receive canagliflozin (JNJ-28431754) 100 mg once daily during the first 13 weeks, then the dose may be increased to 300 mg once daily. Receives: Drug: Canagliflozin, 100 mg; Drug: Canagliflozin, 300 mg |
| Placebo | Placebo comparator | Each patient will receive placebo (inactive medication) once daily. Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Progression of Albuminuria
Progression defined as the development of micro-albuminuria (Urine Albumin Creatinine Ratio [UACR] 30 to 300 milligram per gram [mg/g]) or macroalbuminuria (Albumin/creatinine ratio [ACR] of greater than [>] 300 mg/g) in a participant with baseline normoalbuminuria (ACR less than [<] 30 mg/g) or the development of macro-albuminuria in a participant with baseline microalbuminuria with an ACR increase greater than or equal to (>=) 30 percent from baseline. Participants with macroalbuminuria at baseline (ACR>300 mg/g) were excluded from the analysis. Event rate was estimated based on the time to the first occurrence of the event.
Measured: Up to 3 years
Secondary outcomes (2)
Composite of Cardiovascular (CV) Death Events or Hospitalization for Heart Failure
Analyses were using adjudicated events, that is (i.e.) CV death events or hospitalization due to heart failure, and adjudication of these outcomes by the Endpoint Adjudication Committee (EAC) were done in a blinded fashion. Event rate was estimated based on the time to the first occurrence of the event.
Measured: Approximately 3 years
Cardiovascular (CV) Death
Analyses were using adjudicated events, i.e. CV death events, and adjudication of these outcomes by the Endpoint Adjudication Committee (EAC) were done in a blinded fashion. Event rate was estimated based on the time to the first occurrence of the event.
Measured: Approximately 3 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Nov 2013 (estimated)
- Study start16 Jan 2014
- Primary completion23 Feb 2017
- Study completion23 Feb 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (29)Papers the sponsor has linked to this study.
- Other trials for Diabetes Mellitus, Type 2Studies of the same condition, open and under way.
- More trials run by Janssen Research & Development, LLCThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 5,813 participants (actual)
Sponsor and investigators
- Lead sponsor
- Janssen Research & Development, LLC
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- The George Institute for Global Health, Australia
- Responsible party
- Sponsor
- Investigators
- Janssen Research & Development, LLC Clinical Trial, Study director, Janssen Research & Development, LLC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01989754
- Sponsor's protocol ID
- CR102647
- Other IDs
- 2013-003050-25, 28431754DIA4003
- Acronym
- CANVAS-R
- Status last verified
- Nov 2018
- First submitted
- 17 Oct 2013
- Last updated
- 11 Dec 2018
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated device
- No
Publications
Heerspink HJL, Collier WH, Chaudhari J, Miao S, Tighiouart H, Appel GB, Caravaca-Fontan F, Floege J, Hannedouche T, Imai E, Jafar TH, Lewis JB, Li PKT, Locatelli F, Maes BD, Neuen BL, Perkovic V, Perrone RD, Remuzzi G, Schena FP, Wanner C, Greene T, Inker LA. A meta-analysis of albuminuria as a surrogate endpoint for kidney failure. Nat Med. 2026 Jan;32(1):281-287. doi: 10.1038/s41591-025-04057-z. Epub 2025 Nov 6.
PubMed 41198855Januzzi JLJ, Sattar N, Vaduganathan M, Magaret CA, Rhyne RF, Liu Y, Masson S, Butler J, Hansen MK. A validated multivariable machine learning model to predict cardio-kidney risk in diabetic kidney disease. Cardiovasc Diabetol. 2025 May 15;24(1):213. doi: 10.1186/s12933-025-02779-5.
PubMed 40375260Doi Y, Hamano T, Yamaguchi O, Isaka Y. Canagliflozin may increase thromboembolic events in males with erythrocytosis but not in females. Blood Adv. 2025 Jul 8;9(13):3202-3212. doi: 10.1182/bloodadvances.2025016320.
PubMed 40239057Nguyen TN, Yu J, Perkovic V, Jardine M, Mahaffey KW, Chow CK, Arnott C, Lindley RI. The Efficacy and Safety of Canagliflozin by Frailty Status in Participants of the CANVAS and CREDENCE Trials. J Am Geriatr Soc. 2025 Jun;73(6):1787-1796. doi: 10.1111/jgs.19444. Epub 2025 Mar 19.
PubMed 40105285Vaduganathan M, Cannon CP, Jardine MJ, Heerspink HJL, Arnott C, Neuen BL, Sarraju A, Gogate J, Seufert J, Neal B, Perkovic V, Mahaffey KW, Kosiborod MN. Effects of canagliflozin on total heart failure events across the kidney function spectrum: Participant-level pooled analysis from the CANVAS Program and CREDENCE trial. Eur J Heart Fail. 2024 Sep;26(9):1967-1975. doi: 10.1002/ejhf.3292. Epub 2024 Jun 26.
PubMed 38932575Tangri N, Ferguson TW, Bamforth RJ, Leon SJ, Arnott C, Mahaffey KW, Kotwal S, Heerspink HJL, Perkovic V, Fletcher RA, Neuen BL. Machine learning for prediction of chronic kidney disease progression: Validation of the Klinrisk model in the CANVAS Program and CREDENCE trial. Diabetes Obes Metab. 2024 Aug;26(8):3371-3380. doi: 10.1111/dom.15678. Epub 2024 May 28.
PubMed 38807510Natale P, Tunnicliffe DJ, Toyama T, Palmer SC, Saglimbene VM, Ruospo M, Gargano L, Stallone G, Gesualdo L, Strippoli GF. Sodium-glucose co-transporter protein 2 (SGLT2) inhibitors for people with chronic kidney disease and diabetes. Cochrane Database Syst Rev. 2024 May 21;5(5):CD015588. doi: 10.1002/14651858.CD015588.pub2.
PubMed 38770818Sharma A, Razaghizad A, Joury A, Levin A, Bajaj HS, Mancini GBJ, Wong NC, Slee A, Ang FG, Rapattoni W, Neuen BL, Arnott C, Perkovic V, Mahaffey KW. Primary and Secondary Cardiovascular and Kidney Prevention With Canagliflozin: Insights From the CANVAS Program and CREDENCE Trial. J Am Heart Assoc. 2024 Feb 6;13(3):e031586. doi: 10.1161/JAHA.123.031586. Epub 2024 Jan 19.
PubMed 38240199Yu J, Sweeting AN, Gianacas C, Houston L, Lee V, Fletcher RA, Perkovic V, Li Q, Neuen BL, Berwanger O, Heerspink HJL, de Zeeuw D, Arnott C. The effects of canagliflozin in type 2 diabetes in subgroups defined by population-specific body mass index: Insights from the CANVAS Program and CREDENCE trial. Diabetes Obes Metab. 2023 Dec;25(12):3724-3735. doi: 10.1111/dom.15267. Epub 2023 Sep 6.
PubMed 37671609Fletcher RA, Arnott C, Rockenschaub P, Schutte AE, Carpenter L, Vaduganathan M, Agarwal R, Bakris G, Chang TI, Heerspink HJL, Jardine MJ, Mahaffey KW, Neal B, Pollock C, Jun M, Rodgers A, Perkovic V, Neuen BL. Canagliflozin, Blood Pressure Variability, and Risk of Cardiovascular, Kidney, and Mortality Outcomes: Pooled Individual Participant Data From the CANVAS and CREDENCE Trials. J Am Heart Assoc. 2023 Jul 4;12(13):e028516. doi: 10.1161/JAHA.122.028516. Epub 2023 Jun 22.
PubMed 37345834Borisov AN, Kutz A, Christ ER, Heim MH, Ebrahimi F. Canagliflozin and Metabolic Associated Fatty Liver Disease in Patients With Diabetes Mellitus: New Insights From CANVAS. J Clin Endocrinol Metab. 2023 Oct 18;108(11):2940-2949. doi: 10.1210/clinem/dgad249.
PubMed 37149821Ferrannini G, Pollock C, Natali A, Yavin Y, Mahaffey KW, Ferrannini E. Extremes of both weight gain and weight loss are associated with increased incidence of heart failure and cardiovascular death: evidence from the CANVAS Program and CREDENCE. Cardiovasc Diabetol. 2023 Apr 29;22(1):100. doi: 10.1186/s12933-023-01832-5.
PubMed 37120538Nunes JC, Yu J, Arnott C, Jardine MJ, Perkovic V, Mahaffey KW. Canagliflozin, mental health adverse events and diabetes: Exploratory analysis of the CREDENCE trial and CANVAS Program. Diabetes Obes Metab. 2022 Dec;24(12):2459-2464. doi: 10.1111/dom.14832. Epub 2022 Aug 19. No abstract available.
PubMed 35938182Young TK, Li JW, Kang A, Heerspink HJL, Hockham C, Arnott C, Neuen BL, Zoungas S, Mahaffey KW, Perkovic V, de Zeeuw D, Fulcher G, Neal B, Jardine M. Effects of canagliflozin compared with placebo on major adverse cardiovascular and kidney events in patient groups with different baseline levels of HbA1c, disease duration and treatment intensity: results from the CANVAS Program. Diabetologia. 2021 Nov;64(11):2402-2414. doi: 10.1007/s00125-021-05524-1. Epub 2021 Aug 26.
PubMed 34448033Yu J, Li J, Leaver PJ, Arnott C, Huffman MD, Udell JA, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Matthews DR, Shaw W, Rosenthal N, Neal B, Figtree GA. Effects of canagliflozin on myocardial infarction: a post hoc analysis of the CANVAS programme and CREDENCE trial. Cardiovasc Res. 2022 Mar 16;118(4):1103-1114. doi: 10.1093/cvr/cvab128.
PubMed 33826709
Study at a glance
From the registry record, last updated by the sponsor on 11 Dec 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Multicenter, Double-Blind, Parallel, Placebo-Controlled Study of the Effects of Canagliflozin on Renal Endpoints in Adult Subjects With Type 2 Diabetes Mellitus
- ClinicalTrials.gov ID
- NCT01989754
- Acronym / sponsor ID
- CANVAS-R / CR102647
- Conditions
- Diabetes Mellitus, Type 2, Albuminuria
- Keywords
- Albuminuria, Canagliflozin, Cardiovascular outcomes, Type 2 Diabetes Mellitus, T2DM, JNJ-28431754, Antihyperglycemic Agent
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 5,813 participants (actual)
- Lead sponsor
- Janssen Research & Development, LLCIndustry (pharma, biotech, devices)
- Collaborators
- The George Institute for Global Health, Australia
- Study start
- 16 Jan 2014 (actual)
- Primary completion
- 23 Feb 2017 (actual)
- Study completion
- 23 Feb 2017 (actual)
- First posted
- 21 Nov 2013 (estimated)
- Results
- Posted 11 Dec 2018
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to assess the effect of canagliflozin compared to placebo on progression of albuminuria in participants with Type 2 Diabetes Mellitus receiving standard care but with inadequate glycemic control and at elevated risk of cardiovascular events.
Detailed description
The study will be conducted in adult participants with Type 2 Diabetes Mellitus (T2DM), receiving standard of care for hyperglycemia and cardiovascular (CV) risk factors, who have either a history of a prior CV event or 2 or more risk factors for a CV event. Participants will be randomly assigned in a 1:1 ratio to canagliflozin or matching placebo to be taken once daily. Canagliflozin will be provided at a dose of 100 mg/day through Week 13 and then increased at the discretion of the investigator to a dose of 300 mg/day, if the participant requires additional glycemic control and is tolerating the 100 mg dose.
The study consists of a 2-week screening period and a double-blind treatment period lasting between 78 and 156 weeks; study completion is targeted for when the last subject randomized has approximately 78 weeks of follow-up or when 688 major adverse cardiovascular events are accumulated between CANVAS and CANVAS-R. A total of 5,700 participants are targeted to be recruited into the study. Participants can be either drug naïve to antihyperglycemic agents, using monotherapy, or using combination of antihyperglycemic therapy for the control of blood glucose levels.
The completion target was reached in February 2017.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Canagliflozin (JNJ-28431754) | Experimental | Drug: Canagliflozin, 100 mg, Drug: Canagliflozin, 300 mgEach patient will receive canagliflozin (JNJ-28431754) 100 mg once daily during the first 13 weeks, then the dose may be increased to 300 mg once daily. |
| Placebo | Placebo comparator | Drug: PlaceboEach patient will receive placebo (inactive medication) once daily. |
Who may qualify
- Ages
- 30 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (4 listed)
- Must have a diagnosis of type 2 diabetes mellitus
- Must have inadequate diabetes control (as defined by glycosylated hemoglobin level >=7.0% to <=10.5% at screening)
- Greater than or equal to (>=) 30 yrs old with history of cardiovascular (CV) event, or >= 50 yrs old with high risk of CV events
- Must be either not on antihyperglycemic agents (AHA) therapy, or on AHA monotherapy, or combination AHA therapy with any approved agent for the control of blood glucose levels.
Key exclusion criteria (6 listed)
- History of diabetic ketoacidosis, type 1 diabetes mellitus, pancreas or beta-cell transplantation, or diabetes secondary to pancreatitis or pancreatectomy
- History of one or more severe hypoglycemic episode within 6 months before screening
- History of hereditary glucose-galactose malabsorption or primary renal glucosuria
- Ongoing, inadequately controlled thyroid disorder
- Renal disease that required treatment with immunosuppressive therapy or a history of chronic dialysis or renal transplant
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PlaceboOne placebo capsule taken orally (by mouth) once daily for 156 weeks | Drug | Placebo |
| Canagliflozin, 100 mgOne 100 mg capsule taken orally (by mouth) once daily | Drug | Canagliflozin (JNJ-28431754) |
| Canagliflozin, 300 mgOne 300 mg capsule taken orally (by mouth) once daily | Drug | Canagliflozin (JNJ-28431754) |
Primary outcome
Progression of Albuminuria
Time frame: Up to 3 years
Progression defined as the development of micro-albuminuria (Urine Albumin Creatinine Ratio [UACR] 30 to 300 milligram per gram [mg/g]) or macroalbuminuria (Albumin/creatinine ratio [ACR] of greater than [>] 300 mg/g) in a participant with baseline normoalbuminuria (ACR less than [<] 30 mg/g) or the development of macro-albuminuria in a participant with baseline microalbuminuria with an ACR increase greater than or equal to (>=) 30 percent from baseline. Participants with macroalbuminuria at baseline (ACR>300 mg/g) were excluded from the analysis. Event rate was estimated based on the time to the first occurrence of the event.
2 secondary outcomes
Composite of Cardiovascular (CV) Death Events or Hospitalization for Heart Failure
Time frame: Approximately 3 years
Cardiovascular (CV) Death
Time frame: Approximately 3 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 11 Dec 2018.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 41198855Heerspink HJL, Collier WH, Chaudhari J, Miao S, Tighiouart H, Appel GB, Caravaca-Fontan F, Floege J, Hannedouche T, Imai E, Jafar TH, Lewis JB, Li PKT, Locatelli F, Maes BD, Neuen BL, Perkovic V, Perrone RD, Remuzzi G, Schena FP, Wanner C, Greene T, Inker LA. A meta-analysis of albuminuria as a surrogate endpoint for kidney failure. Nat Med. 2026 Jan;32(1):281-287. doi: 10.1038/s41591-025-04057-z. Epub 2025 Nov 6.
- Derived from this study: PubMed 40375260Januzzi JLJ, Sattar N, Vaduganathan M, Magaret CA, Rhyne RF, Liu Y, Masson S, Butler J, Hansen MK. A validated multivariable machine learning model to predict cardio-kidney risk in diabetic kidney disease. Cardiovasc Diabetol. 2025 May 15;24(1):213. doi: 10.1186/s12933-025-02779-5.
- Derived from this study: PubMed 40239057Doi Y, Hamano T, Yamaguchi O, Isaka Y. Canagliflozin may increase thromboembolic events in males with erythrocytosis but not in females. Blood Adv. 2025 Jul 8;9(13):3202-3212. doi: 10.1182/bloodadvances.2025016320.
- Derived from this study: PubMed 40105285Nguyen TN, Yu J, Perkovic V, Jardine M, Mahaffey KW, Chow CK, Arnott C, Lindley RI. The Efficacy and Safety of Canagliflozin by Frailty Status in Participants of the CANVAS and CREDENCE Trials. J Am Geriatr Soc. 2025 Jun;73(6):1787-1796. doi: 10.1111/jgs.19444. Epub 2025 Mar 19.
- Derived from this study: PubMed 38932575Vaduganathan M, Cannon CP, Jardine MJ, Heerspink HJL, Arnott C, Neuen BL, Sarraju A, Gogate J, Seufert J, Neal B, Perkovic V, Mahaffey KW, Kosiborod MN. Effects of canagliflozin on total heart failure events across the kidney function spectrum: Participant-level pooled analysis from the CANVAS Program and CREDENCE trial. Eur J Heart Fail. 2024 Sep;26(9):1967-1975. doi: 10.1002/ejhf.3292. Epub 2024 Jun 26.
- Derived from this study: PubMed 38807510Tangri N, Ferguson TW, Bamforth RJ, Leon SJ, Arnott C, Mahaffey KW, Kotwal S, Heerspink HJL, Perkovic V, Fletcher RA, Neuen BL. Machine learning for prediction of chronic kidney disease progression: Validation of the Klinrisk model in the CANVAS Program and CREDENCE trial. Diabetes Obes Metab. 2024 Aug;26(8):3371-3380. doi: 10.1111/dom.15678. Epub 2024 May 28.
- Derived from this study: PubMed 38770818Natale P, Tunnicliffe DJ, Toyama T, Palmer SC, Saglimbene VM, Ruospo M, Gargano L, Stallone G, Gesualdo L, Strippoli GF. Sodium-glucose co-transporter protein 2 (SGLT2) inhibitors for people with chronic kidney disease and diabetes. Cochrane Database Syst Rev. 2024 May 21;5(5):CD015588. doi: 10.1002/14651858.CD015588.pub2.
- Derived from this study: PubMed 38240199Sharma A, Razaghizad A, Joury A, Levin A, Bajaj HS, Mancini GBJ, Wong NC, Slee A, Ang FG, Rapattoni W, Neuen BL, Arnott C, Perkovic V, Mahaffey KW. Primary and Secondary Cardiovascular and Kidney Prevention With Canagliflozin: Insights From the CANVAS Program and CREDENCE Trial. J Am Heart Assoc. 2024 Feb 6;13(3):e031586. doi: 10.1161/JAHA.123.031586. Epub 2024 Jan 19.
- Derived from this study: PubMed 37671609Yu J, Sweeting AN, Gianacas C, Houston L, Lee V, Fletcher RA, Perkovic V, Li Q, Neuen BL, Berwanger O, Heerspink HJL, de Zeeuw D, Arnott C. The effects of canagliflozin in type 2 diabetes in subgroups defined by population-specific body mass index: Insights from the CANVAS Program and CREDENCE trial. Diabetes Obes Metab. 2023 Dec;25(12):3724-3735. doi: 10.1111/dom.15267. Epub 2023 Sep 6.
- Derived from this study: PubMed 37345834Fletcher RA, Arnott C, Rockenschaub P, Schutte AE, Carpenter L, Vaduganathan M, Agarwal R, Bakris G, Chang TI, Heerspink HJL, Jardine MJ, Mahaffey KW, Neal B, Pollock C, Jun M, Rodgers A, Perkovic V, Neuen BL. Canagliflozin, Blood Pressure Variability, and Risk of Cardiovascular, Kidney, and Mortality Outcomes: Pooled Individual Participant Data From the CANVAS and CREDENCE Trials. J Am Heart Assoc. 2023 Jul 4;12(13):e028516. doi: 10.1161/JAHA.122.028516. Epub 2023 Jun 22.
- Derived from this study: PubMed 37149821Borisov AN, Kutz A, Christ ER, Heim MH, Ebrahimi F. Canagliflozin and Metabolic Associated Fatty Liver Disease in Patients With Diabetes Mellitus: New Insights From CANVAS. J Clin Endocrinol Metab. 2023 Oct 18;108(11):2940-2949. doi: 10.1210/clinem/dgad249.
- Derived from this study: PubMed 37120538Ferrannini G, Pollock C, Natali A, Yavin Y, Mahaffey KW, Ferrannini E. Extremes of both weight gain and weight loss are associated with increased incidence of heart failure and cardiovascular death: evidence from the CANVAS Program and CREDENCE. Cardiovasc Diabetol. 2023 Apr 29;22(1):100. doi: 10.1186/s12933-023-01832-5.
Related trials for Diabetes Mellitus, Type 2
Not yet recruitingPhase 3
Efficacy and Safety of Once-Weekly SHR-3167 Compared With Once-Daily Insulin Glargine in Adults With Insulin-Naive Type 2 Diabetes
Type 2 Diabetes
Active, not recruiting
Digital Reinforcement of Motivational Interviewing Micro-Skills Among Primary Care Healthcare Professionals
Hypertension (Without Type 2 Diabetes Mellitus)
Recruiting
Investigating Vascular Properties of HEMI and SPG Signals in Individuals With or at Risk for Chronic Kidney Disease
Chronic Kidney Disease, Hypertension (HTN)
Not yet recruitingPhase 3
A Study to Evaluate the Effectiveness and Safety of the Drug AZD6234 for Managing Weight in Adults Who Are Obese or Overweight. These Participants May or May Not Also Have Type 2 Diabetes
Obesity, Overweight
Not yet recruiting
Impact of Endoscopic Sleeve Gastroplasty (ESG) in Obese Adults With Type 2 Diabetes (T2D)
Type 2 Diabetes Mellitus (T2D), Obesity (BMI>30)
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Janssen Research & Development, LLC Clinical Trial study director
Janssen Research & Development, LLC
341 sites in 25 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Canagliflozin, 100 mg and Canagliflozin, 300 mg in people with Diabetes Mellitus, Type 2 and Albuminuria, run by Janssen Research & Development, LLC at 341 sites in 25 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 11 Dec 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 341 sites in United States, Spain, Netherlands, United Kingdom, Ukraine and 20 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 11 Dec 2018). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Progression of Albuminuria (time frame: Up to 3 years). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01989754, which also lists 29 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Dec 2018.