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Cgz4.5
Canagliflozin – Forschung
Überwiegend Mechanismus / Beobachtung
35 begutachtete Studien
Was die Evidenz sagt
Überwiegend Mechanismus / Beobachtung
Die meisten Studien zu Canagliflozin sind mechanistisch oder beobachtend statt RCTs, die einen klinischen Effekt messen — betrachte die Ergebnisse als vorläufig.
Die meiste Evidenz stammt aus hochwertigen Meta-Analysen und randomisierten Studien, veröffentlicht 2015–2026 mit einer typischen Studiengröße von 2,916 Teilnehmenden.
Basierend auf 35 Studien · 7 Meta-Analysen · 7 RCTs · 958,902 Teilnehmende insgesamt
Konfidenz
Hohe Konfidenz
Nach Outcome
Glucose & weightSenkt den Blutzucker über die renale Glukoseausscheidung (der zugelassene Diabetes-Effekt) · Wochen bis Monate
Überwiegend Mechanismus / Beobachtung24 Studien
Cardiovascular & heart failureDie SGLT2-Klasse senkt kardiovaskuläre Mortalität, Herzinsuffizienz-bedingte Hospitalisierungen und das Fortschreiten von Nierenerkrankungen — auch bei Nicht-Diabetikern · Monate bis Jahre
Überwiegend Mechanismus / Beobachtung23 Studien
Safety profile
Überwiegend Mechanismus / Beobachtung5 Studien
Lifespan & aging (preclinical)
Überwiegend Mechanismus / Beobachtung3 Studien
Aktives Forschungsgebiet
30 Studien in den letzten 5 Jahren · Neueste Meta-Analyse: 2026
201520202026
1Systematische Übersicht2026
The results of each study have a direct effect on clinical care for patients who often present to physicians who are not endocrinologists.
Escudero C et al. · Annals of internal medicine (2026)
One additional study explores the risk for urogenital infections in patients with diabetes receiving sodium-glucose cotransporter-2 inhibitors (SGLT-2is) versus GLP-1RAs.
Another study explores cardiovascular, kidney, and safety outcomes with canagliflozin (an SGLT-2i).
The last article explores the efficacy and safety of finerenone in T2DM.
SGLT2 inhibitors combined with insulin pump therapy improve glycemic outcomes in T1D but elevate DKA risk, underscoring the need for individualized treatment, careful dosing, and vigilant monitoring.
Oktavian P et al. · Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (2026)
SGLT2 inhibitors significantly increased time-in-range compared with insulin pump therapy alone (MD 11.89%, [9.38 to 14.40]; I2 = 43.1%, P < .001).
Low- and high-dose SGLT2 inhibitors caused a comparable increase in the time-in-range (11.89% and 12.22%, respectively).
Glycated hemoglobin decreased significantly (MD -0.30%, [-0.41 to -0.20]); however, SGLT2 inhibitors increased DKA risk (OR 3.33 [2.10 to 5.27]; number needed to harm = 27).
Nadgir U, Ali SR, Gogate J, Shaw W, Antunes J, Fonseca S. · Annals of internal medicine (2025)
Participants Children and adolescents aged 10 years or older with T2DM (hemoglobin A 1c [HbA 1c ] ≥6.5% to ≤11%).
Participants with week 12 readings of 7% or higher for HbA 1c and at least 60 mL/min/1.73 m 2 for estimated glomerular filtration rate were randomly assigned again at week 13 to either keep receiving 100 mg of canagliflozin (or placebo) or have their dose uptitrated to 300 mg (or placebo).
At week 26, HbA 1c reduction from baseline was significantly greater with canagliflozin than placebo (difference in least-squares means, -0.76% [95% CI, -1.25% to -0.27%]; P = 0.002).
5Beobachtungsstudien=657,134 · very large study2026
Conclusions This analysis found no evidence of a statistically significantly increased risk of prostatitis among adult male patients with T2DM receiving canagliflozin compared with the other AHAs evaluated in this study.
Yuan Z, Jeffcoat CH, Ali SR, Sena AG, Schuemie MJ, Ryan PB, Fonseca SA. · PloS one (2026)
Conclusions This analysis found no evidence of a statistically significantly increased risk of prostatitis among adult male patients with T2DM receiving canagliflozin compared with the other AHAs evaluated in this study.
Propensity score matching achieved good balance in all available covariates, and effect estimates were relatively close to a hazard ratio of 1.0, varying on both sides of the null effect.
Minimum detectable relative risks were low in most databases, and meta-analytic estimates were near 1.0, with all upper bounds <1.50.
However, definitive evidence from large-scale, multicenter randomized controlled trials is warranted to confirm its efficacy and safety, and to optimize perioperative management strategies.
Dong Y, Zhou F, Chi L, Mu J. · Reviews in cardiovascular medicine (2026)
These mechanisms are highly relevant to mitigating key pathophysiological insults in the perioperative period.
While current clinical data are limited to observational studies, they suggest promising benefits for canagliflozin in reducing postoperative cardiovascular complications.
Canagliflozin shows considerable potential as a therapeutic agent for patients with heart failure related to cardiac surgery.
Linezolid and dapagliflozin co-administration may lead to severe pancytopenia.
Gomes DS et al. · Pulmonology (2026)
RIF significantly reduced the plasma exposure of DPP4i (saxagliptin, gemigliptin, evogliptin) and canagliflozin, while other SGLT2i (dapagliflozin, empagliflozin, ertugliflozin) were minimally affected.
This analysis identifies no significant evidence of infection-related adverse events related to GLP-1 receptor agonist or SGLT2 inhibitor prescription.
Zeng BS et al. · Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases (2026)
This analysis identifies no significant evidence of infection-related adverse events related to GLP-1 receptor agonist or SGLT2 inhibitor prescription.
Published in Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases (2026)
Chiriacò M, Tricò D, Giannoni A, Sacchetta L, Nesti L, Baldi S, Scozzaro T, Castiglione V, Natali A, Ferrannini E. · Diabetologia (2026)
Results In the placebo group, LNS intake increased the risk of heart failure/cardiovascular death vs HS (adjusted HR [adjHR] 1.56 [95% CI 1.10, 2.23]).
Canagliflozin significantly reduced this risk in the LNS group (adjHR 0.48 [95% CI 0.33, 0.70]) but not in the HS group (adjHR 1.05 [95% CI 0.73, 1.53]).
Continuous modelling revealed a near-linear rise in heart failure/cardiovascular death risk as sodium intake decreased in placebo recipients, while this gradient was flattened with canagliflozin.
Prospective trials are warranted to confirm these findings and explore underlying mechanisms.
Kumari K, Bai A, Geeta F, Wadhwani N, Kumar R, Kumar A, Kumari R, Bai L, Muskan F, Kashish F, Yousafzai M. · Endocrinology, diabetes & metabolism (2026)
SGLT2 inhibitors were associated with a significantly lower risk of all-cause dementia (HR = 0.74; 95% CI: 0.62-0.87), Alzheimer's disease (HR = 0.62; 95% CI: 0.52-0.74), and vascular dementia (HR = 0.54; 95% CI: 0.49-0.60) compared to DPP-4 inhibitors.
Subgroup findings were largely consistent across age and sex.
Dapagliflozin and empagliflozin showed significant benefit, while canagliflozin did not.
Conclusion Combined canagliflozin and semaglutide therapy demonstrated superior short-term benefits in reducing albuminuria, improving metabolic control, and attenuating systemic inflammation in early DKD, supporting further long-term evaluation of renal and cardiovascular outcomes.
Long W, Ningning L, Weijun H. · Pakistan journal of pharmaceutical sciences (2026)
Results At 24 weeks, combination therapy achieved significantly greater reductions in UACR compared with monotherapy and placebo (P < 0.05).
Measurements of HbA1c, fasting glucose, HOMA-IR, lipid parameters, and inflammatory markers showed better results in the combination therapy group compared to single-agent therapy (P < 0.05).
Across treatment groups, a small reduction in eGFR was observed without significant between-group differences.
These findings support the need for prospective trials to further investigate the integration of SGLT2i into cancer patient management to enhance cardiovascular outcomes.
Bhalraam U, Veerni RB, Paddock S, Meng J, Piepoli M, López-Fernández T, Tsampasian V, Vassiliou VS. · European journal of preventive cardiology (2026)
SGLT2i use reduced HF hospitalizations by 51% (RR 0.49, 95% CI 0.36-0.66, I² = 28%, P < 0.01) and new HF diagnoses by 71% (RR 0.29, 95% CI 0.10-0.87, I² = 71%).
Conclusion SGLT2i significantly lower the risk of HF hospitalization and new HF diagnoses among cancer patients and survivors, with particularly pronounced benefits in breast cancer patients receiving anthracycline-based chemotherapy.
These findings support the need for prospective trials to further investigate the integration of SGLT2i into cancer patient management to enhance cardiovascular outcomes.
15Beobachtungsstudien=80,670 · very large study2026
Overall, evidence from placebo-controlled trials was robust, whereas certainty was lower for indirect estimates, highlighting the need for drug-specific evaluation in clinical practice.
Canagliflozin 100-300 mg significantly reduced UACR, whereas dapagliflozin had no effect.
Conclusions In patients with T2DM and CKD, SGLT2 inhibitors provide the most consistent renal protection, while GLP-1 receptor agonists offer additional but variable benefits.
Dapagliflozin showed the greatest efficacy, and canagliflozin most strongly reduced albuminuria, highlighting meaningful heterogeneity across agents.
Bayes-Genis A, Cai A, Liu Y, Pandey A, Pop-Busui R, Hansen M, Januzzi JL. · European journal of heart failure (2025)
At baseline, 45% of participants had heart stress.
Canagliflozin significantly reduced risks in individuals with heart stress, including the primary composite (hazard ratio [HR] 0.72, 95% confidence interval [CI] 0.62-0.84), kidney composite (HR 0.65, 95% CI 0.53-0.79), and HF hospitalization (HR 0.68, 95% CI 0.54-0.85).
Benefits were less pronounced in those without heart stress.
17Beobachtungsstudien=4,401 · very large study2025
This supports the use of canagliflozin in people with CKD, not only for end-organ protection, but also to improve glycaemic control and reduce exposure to insulin and its associated adverse effects.
Beal B, Buizen L, Yeung EK, Heath L, Houston L, Cherney DZI, Jardine M, Pollock C, Arnott C, Kotwal SS, Heerspink HJL, Perkovic V, Neuen BL. · Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (2025)
The primary outcome was insulin initiation or a >25% insulin dose intensification (in those not receiving and receiving insulin at baseline, respectively).
Results Among 4401 participants, 2884 (65.5%) were receiving insulin at baseline; these participants were more likely to have lower estimated glomerular filtration rate, higher albuminuria and a longer duration of diabetes (all P < .001).
Sustained insulin dose reductions of >50% were achieved more frequently with canagliflozin than placebo [HR 1.49 (95% CI 1.15-1.91)], although no difference in insulin discontinuation was observed between treatment arms.
Further future research in the coming years may provide more data and information on the protective role of canagliflozin in patients with T2DM.
Aftabi H, Aftabi R. · BMC endocrine disorders (2025)
The data were analyzed and interpreted at 95% Confidence Interval with reference to placebo-controlled randomized controlled trails (RCTs).
At 100 mg dose, canagliflozin lowers systolic blood pressure compared to that of placebo (effect size: -0.03 (-0.07, 0.00), (P = 0.06)].
Conclusion This systematic review and meta-analysis highlight that although canagliflozin does not project significant decrease on BMI and HbA1c, yet in 100 mg doses significantly reduces SBP in patients with T2DM.
19Systematische Übersichtn=17,809 · very large study2025
Among SGLT2i, canagliflozin showed greatest ACM, CVD, and HHF benefit.
Su AY, Csere MM, Shan R, Pasupuleti V, Valenzuela GV, Hernandez AV. · Diabetes research and clinical practice (2025)
Compared to control, SGLT2i significantly reduced ACM (HR 0.87, 95 %CI 0.78 to 0.98, low quality of evidence [QoE]), ACH (HR 0.74, 95 %CI 0.62 to 0.88, high QoE), and HHF (HR 0.70, 95 %CI 0.63 to 0.77, low QoE); but not CVD (HR 0.87, 95 %CI 0.76 to 1.00, very low QoE).
Canagliflozin ranked highest in decreasing ACM (p-score = 0.86), CVD (p-score = 0.82), and HHF (p-score = 0.88).
In patients with HF and T2DM, SGLT2i class effects include ACM, ACH, and HHF reduction.
Compared with empagliflozin, liraglutide may not be a cost-effective treatment option for patients with T2D who were not well-controlled with metformin.
Wang L, Wang Y, Zhao Q. · European journal of clinical pharmacology (2026)
Empagliflozin demonstrated cost-effectiveness when the treatment with either empagliflozin or semaglutide would have continued indefinitely.
Compared with empagliflozin, liraglutide may not be a cost-effective treatment option for patients with T2D who were not well-controlled with metformin.