Canagliflozin and Gout – New CANVAS Sub-Analysis Published

Another Possible Benefit of SGLT2i’s

An interesting sub-analysis was just published in the LANCET, evaluating the impact of canagliflozin on gout in type 2 diabetes:

Canagliflozin Seems to Reduce the Risk

In this analysis they found that people taking canagliflozin had a 6.7% reduction in serum urate concentration (percentage difference –6·7%, 95% CI –7·3 to –6·1).  During follow-up, 80 individuals reported an episode of gout flare and 147 commenced a drug for gout. The occurrence of gout flare or the need for  treatment for gout was 47% lower in participants treated with canagliflozin than in those who received placebo (HR 0·53, 95% CI 0·40–0·71; p<0·0001).

What Does This Mean for Practice

  • Canagliflozin appears to lead to a significant reduction in a patient’s gout risk
  • This data warrants further study, but these results look promising
  • In the meantime, if there is a patient who is not reaching A1C targets, is a candidate for SGLT2i and has a history of gout, clinicians may wish to consider canagliflozin