Diabetes Mellitus, Type 2Phase 3CREDENCENCT02065791
Evaluation of the Effects of Canagliflozin on Renal and Cardiovascular Outcomes in Participants With Diabetic Nephropathy
A Phase 3 study testing Canagliflozin in people with Diabetes Mellitus, Type 2 and Diabetic Nephropathy, run by Janssen Research & Development, LLC at 575 sites in 34 countries.
Trial summary
The goal of this study is to assess whether canagliflozin has a renal and vascular protective effect in reducing the progression of renal impairment relative to placebo in participants with type 2 diabetes mellitus (T2DM), Stage 2 or 3 chronic kidney disease (CKD) and macroalbuminuria, who are receiving standard of… Read more about this study
- Who is it for?
- Ages 30 years and older
- Conditions the study is for
- Diabetes Mellitus, Type 2, Diabetic Nephropathy
- What is being tested?
- Canagliflozin
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 4,401 participants
- Where
- 575 sitesin 34 countries
- Study dates
- 17 Feb 2014to 30 Oct 2018
- Phase
- Phase 3
- 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
- Type 2 diabetes mellitus with a hemoglobin A1c (HbA1c) greater than or equal to (>=) 6.5 percent (%) and less than or equal to (<=) 12.0%, with an estimated glomerular filtration rate (eGFR) of >= 30 milliliter (mL)/minute (min)/1.73meter (m)^2 and less than (<) 90 mL/min/1.73 m^2
- Participants need to be on a stable maximum tolerated labeled daily dose of an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) for at least 4 weeks prior to randomization
- Must have a urine albumin to creatinine ratio (UACR) of greater than (>) 300 milligram (mg)/gram (g) and <= 5000 mg/g
Who cannot join
- History of diabetic ketoacidosis or type 1 diabetes mellitus
- History of hereditary glucose-galactose malabsorption or primary renal glucosuria
- Renal disease that required treatment with immunosuppressive therapy
- Known significant liver disease
- Current or history of New York Heart Association (NYHA) Class IV heart failure
- Blood potassium level >5.5 millimole (mmol)/liter (L) during Screening
Trial locations and contacts
575 sites in 34 countries.
575 sites in 34 countries
United States152 sites
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Albany, New York
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Albuquerque, New Mexico
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Anderson, South Carolina
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Annapolis, Maryland
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Arlington, Texas
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Asheville, North Carolina
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Atlanta, Georgia
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Augusta, Georgia
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Bakersfield, California
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Baltimore, Maryland
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Beaver, Pennsylvania
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Beltsville, Maryland
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Bennington, Vermont
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Bethlehem, Pennsylvania
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Binghamton, New York
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Birmingham, Alabama
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Bluefield, Virginia
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Boston, Massachusetts
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Buffalo, New York
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Burlington, Vermont
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Calabash, North Carolina
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Charlotte, North Carolina
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Chattanooga, Tennessee
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Chesterfield, Missouri
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Chicago, Illinois
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Chula Vista, California
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Cincinnati, Ohio
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Columbia, South Carolina
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Columbus, Georgia
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Columbus, Ohio
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Coral Springs, Florida
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Corpus Christi, Texas
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Corsicana, Texas
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Council Bluffs, Iowa
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Covina, California
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Crystal Lake, Illinois
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Dallas, Texas
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Denver, Colorado
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Doral, Florida
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Downey, California
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Durham, North Carolina
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Eatontown, New Jersey
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Edinburg, Texas
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Flint, Michigan
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Fort Wayne, Indiana
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Fort Worth, Texas
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Fountain Valley, California
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Fremont, Nebraska
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Golden, Colorado
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Great Neck, New York
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Greensboro, North Carolina
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Greenville, North Carolina
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Gurnee, Illinois
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Hawthorne, California
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Hialeah, Florida
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High Point, North Carolina
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Houston, Texas
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Huntington, West Virginia
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Hyattsville, Maryland
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Indianapolis, Indiana
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Inglewood, California
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Jackson, Mississippi
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Jacksonville, Florida
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Kansas City, Missouri
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Kenner, Louisiana
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Knoxville, Tennessee
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Laguna Hills, California
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Lake Success, New York
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Lakewood, California
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Lakewood, Colorado
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Lancaster, South Carolina
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Las Vegas, Nevada
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Lincoln, Nebraska
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Little Rock, Arkansas
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Long Beach, California
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Los Angeles, California
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Louisville, Kentucky
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Lynwood, California
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Maumee, Ohio
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Mechanicsville, Virginia
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Memphis, Tennessee
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Merrillville, Indiana
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Mesquite, Texas
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Miami, Florida
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Miami Springs, Florida
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Michigan City, Indiana
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Milwaukee, Wisconsin
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Montgomery, Alabama
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Morehead City, North Carolina
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Morganton, North Carolina
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Mount Prospect, Illinois
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Muncie, Indiana
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Murrells Inlet, South Carolina
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New Hyde Park, New York
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New York, New York
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Norfolk, Virginia
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North Miami Beach, Florida
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Northridge, California
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Oakland, California
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Ocala, Florida
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Omaha, Nebraska
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Orange, California
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Orangeburg, South Carolina
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Paducah, Kentucky
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Pasadena, California
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Philadelphia, Pennsylvania
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Pittsburgh, Pennsylvania
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Plymouth, Massachusetts
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Port Charlotte, Florida
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Raleigh, North Carolina
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Reno, Nebraska
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Ridgewood, New York
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Riverhead, New York
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Rockport, Maine
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Roseburg, Oregon
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Roseville, California
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Roswell, Georgia
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Sacramento, California
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Salinas, California
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Salt Lake City, Utah
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San Antonio, Texas
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San Diego, California
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San Dimas, California
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Scarborough, Maine
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Schertz, Texas
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Sherwood, Arkansas
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Silver Spring, Maryland
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Smithtown, New York
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Snellville, Georgia
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Spokane, Washington
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Springfield, Massachusetts
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Springfield Gardens, New York
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St Louis, Missouri
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St. Petersburg, Florida
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Stanford, California
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Stockbridge, Georgia
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Suffolk, Virginia
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Sugar Land, Texas
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Sumter, South Carolina
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Tabor City, North Carolina
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Tempe, Arizona
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Temple, Texas
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Tucson, Arizona
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Tustin, California
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Waco, Texas
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Washington, Colorado
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Washington D.C., District of Columbia
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Whiteville, North Carolina
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Whittier, California
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Winfield, Illinois
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Winter Park, Florida
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Worcester, Massachusetts
United Kingdom38 sites
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Aberdeen
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Antrim
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Barry
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Birmingham
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Blackburn
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Bolton
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Bournemouth
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Bradford
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Bristol
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Burbage
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Cardff
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Cardiff
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Carlshalton
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Carmarthen
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Chester
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Darlington
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Doncaster
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Durham
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Ely
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Hampstead
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Harlow
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Huntingdon
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Liskeard
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London
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Middlesbrough
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Royal Leamington Spa
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Salford
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Welwyn Garden City
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Wokingham
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Wolverhampton
Argentina29 sites
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Bahía Blanca
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Buenos Aires
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Ciudad Autonoma Buenos Aires
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Córdoba
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Corrientes
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Godoy Cruz
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Junín
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La Plata
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Zarate, Buenos Aires
Japan26 sites
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Yamanashi
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Yokohama
Brazil22 sites
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Belém
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Brasília
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Curitiba
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Fortaleza
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Mexico22 sites
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Chihuahua City
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Guadalajara
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Mérida
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Mexico City
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Morelia
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Orizaba
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Pachuca
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Querétaro
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San Luis Potosí City
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Tlalnepantla
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Veracruz
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Zapopan
Spain20 sites
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A Coruña
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Almería
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Barcelona
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Burela de Cabo
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Ciudad Real
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Getafe
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Girona
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Madrid
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Santander
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Vic
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Viladecans
Canada18 sites
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Brampton, Ontario
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Edmonton, Alberta
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Greenfield Park, Quebec
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London, Ontario
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Montreal, Quebec
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New Westminster, British Columbia
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Newmarket, Ontario
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Oshawa, Ontario
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Smiths Falls, Ontario
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Thornhill, Ontario
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Toronto, Ontario
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Toronto
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Vancouver, British Columbia
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Vancouver
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Weston, Ontario
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Winnipeg, Manitoba
Hungary18 sites
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Baja
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Balatonfüred
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Budapest
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Debrecen
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Eger
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Esztergom
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Gödöllő
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Gyula
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Hu-4012 Debrecen N/a
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Nyíregyháza
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Pécs
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Szeged
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Veszprém
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Zalaegerszeg
China17 sites
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Beijing
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Changchun
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Changde
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Changsha
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Chengdu
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Chenzhou
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Dalian
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Foshan
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Nanchang
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Nanjing
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Shanghai
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Shenyang
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Wuhan
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Xi'an
Australia16 sites
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Cairns
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Concord
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Darlinghurst
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Elizabeth Vale
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Fremantle
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Gosford
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Heidelberg
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Keswick
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Meadowbrook
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Parkville
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Reservoir
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Richmond
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St Albans
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St Leonards
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Sydney
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Woolloongabba
France16 sites
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Besançon
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Brest
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Colmar
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Corbeil-Essonnes
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Créteil
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Grenoble
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Lyon
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Marseille
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Metz
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Nantes
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Paris
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Pierre-Bénit
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Poitiers
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Saint-Priest-en-Jarez
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Strasbourg
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Toulouse
Russia16 sites
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Arkhangelsk
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Barnaul
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Ivanovo
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Kemerovo
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Moscow
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Novosibirsk
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Saint Petersburg
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Sestroretsk, Saint-Petersburg
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Tomsk
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Ufa
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Volgograd
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Yaroslavl
Poland15 sites
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Bydgoszcz
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Chorzów
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Katowice
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Lodz
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Radom
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Żnin
India14 sites
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Calicut
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Kozhikode
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Lucknow
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Ludhiyāna
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Mysore
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Secunderabad
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Trivandrum
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Vijayawada
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Visakhapatnam
Czechia13 sites
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České Budějovice
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Český Krumlov
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Choceň
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Havlíčkův Brod
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Hradec Kralove-Vekose
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Hradec nad Svitavou
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Jindřichův Hradec
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Olomouc
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Prague
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Slaný
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Trutnov
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Uherské Hradiště
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Ústí nad Labem
Malaysia13 sites
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Batu Caves
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Ipoh
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Johor Bahru
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Kuala Lumpur
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Kuantan
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Malacca
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Perai
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Petaling Jaya
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Seremban
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Sungai Petani, Kedah
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Tampin
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Temerluh
Philippines13 sites
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Cagayan de Oro
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Cebu
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Cebuu City
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Iloilo City
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Lipa City
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Pasay
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Pasig
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Quezon City
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Tagbilaran City
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Taytay
Slovakia11 sites
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Bardejov
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Bratislava
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Košice
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Nitra
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Prievidza
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Púchov
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Štúrovo
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Žilina
Ukraine10 sites
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Chernivtsi
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Dnipropetrovsk
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Ivano-Frankivsk
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Kharkiv
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Kiev
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Kyiv
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Ternopil
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Vinnitsya
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Vinnytsia
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Zaporizhzhya
Colombia9 sites
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Barranquilla
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Bogotá
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Bucaramanga
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Cali
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Floridablanca
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Manizales
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Medellín
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Pasto
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Pereira
Romania9 sites
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Brasov
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Bucharest
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Cluj-Napoca
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Deva
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Iași
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Oradea
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Ploieşti
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Timișoara
South Africa9 sites
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Cape Town
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Durban
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Isipingo Rail
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Johannesburg
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Krugersdorp
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Port Elizabeth
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Pretoria
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Pretoria Gauteng
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Soweto
Bulgaria8 sites
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Blagoevgrad
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Byala
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Golenci
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Pazardzhik
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Pleven
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Plovdiv
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Sofia
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Varna
Germany8 sites
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Bad Kreuznach - Bosenheim
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Cologne
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Dietzenbach
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Dresden
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Essen
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Hamburg
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Hanover
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Münster
New Zealand8 sites
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Auckland
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Christchurch
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Dunedin
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Palmerston North
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Rotorua
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Takapuna Auckland
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Tauranga
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Wellington
South Korea5 sites
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Busan
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Daegu
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Incheon
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Seongnam
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Seoul
Taiwan4 sites
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Kaohsiung City
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New Taipei City
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Taichung
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Taipei
United Arab Emirates3 sites
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Ajman
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Dubai
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Sharjah city
About this study
Official title: A Randomized, Double-blind, Event-driven, Placebo-controlled, Multicenter Study of the Effects of Canagliflozin on Renal and Cardiovascular Outcomes in Subjects With Type 2 Diabetes Mellitus and Diabetic Nephropathy
The goal of this study is to assess whether canagliflozin has a renal and vascular protective effect in reducing the progression of renal impairment relative to placebo in participants with type 2 diabetes mellitus (T2DM), Stage 2 or 3 chronic kidney disease (CKD) and macroalbuminuria, who are receiving standard of care including a maximum tolerated labeled daily dose of an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB).
Read the detailed description
This is a randomized (the study medication is assigned by chance), double-blind (neither physician nor participant knows the identity of the assigned treatment), placebo-controlled (an inactive substance that is compared with a medication to test whether the medication has a real effect), parallel-group, multicenter study of the effects of canagliflozin on renal and cardiovascular outcomes in participants with type 2 diabetes mellitus (T2DM) and diabetic nephropathy, who are receiving standard of care including a maximum tolerated daily dose of an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB).
The study will consist of a pretreatment phase (several weeks), and a double-blind treatment phase (up to approximately 66 months). During the pretreatment phase all participants will also receive diet/exercise counseling for lipid and blood pressure management as well as counseling on renal and cardiovascular (CV) risk factor medication. A post-treatment follow-up contact or visit will take place approximately 30 days after the last dose of study drug or the completion of the study. The total duration of the study is estimated to be about 5 to 5.5 years. Approximately 4,200 participants will be randomized in a 1:1 ratio to canagliflozin or matching placebo. Participants randomized to canagliflozin will receive a dose of 100 mg once daily. The overall safety and tolerability of canagliflozin will be evaluated by collecting information on adverse events, laboratory tests, vital signs (pulse, blood pressure), physical examination, and body weight.
- Conditions
- Diabetes Mellitus, Type 2, Diabetic Nephropathy
- Being tested
- Canagliflozin, Placebo
- Keywords
- Diabetes Mellitus, Type 2, Diabetic Nephropathies, Canagliflozin, JNJ-28431754, End-Stage Kidney Disease, Chronic Kidney Disease, Macroalbuminuria
- Medical subject headings
- Diabetes Mellitus, Type 2, Diabetic Nephropathies, Kidney Failure, Chronic, Renal Insufficiency, Chronic
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
CanagliflozinDrug
One 100 mg over-encapsulated tablet orally once daily
PlaceboDrug
One matching placebo capsule orally (by mouth) once daily
| Study group | Role | What they receive |
|---|---|---|
| Canagliflozin 100 mg | Experimental | Each participant will receive 100 mg of canagliflozin once daily Receives: Drug: Canagliflozin |
| Placebo | Placebo comparator | Each participant will receive matching placebo once daily Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Primary Composite Endpoint of Doubling of Serum Creatinine (DoSC), End-stage Kidney Disease (ESKD), and Renal or Cardiovascular (CV) Death
Primary composite endpoint is the composite of DoSC, ESKD, and renal or CV death. DoSC: from baseline average determination (sustained and confirmed by repeat central laboratory measure after at least 30 days and preferably within 60 days). ESKD: as initiation of maintenance dialysis for at least 30 days, or renal transplantation, or an estimated glomerular filtration rate (eGFR) value of less than (<)15 milliliters per minute per 1.73 square meter (mL/min/1.73 m^2) (sustained and confirmed by repeat central laboratory measure after at least 30 days and preferably within 60 days). Renal death: death in participants who had reached ESKD, died without initiating renal replacement therapy, and no other cause of death was determined via adjudication. Adjudication of these events by Endpoint Adjudication Committee (EAC) was performed in blinded fashion. Event rate estimated based on time to first occurrence of primary composite endpoint are presented.
Measured: Up to 4.6 years
Secondary outcomes (7)
Composite Endpoint of CV Death and Hospitalized Heart Failure (HHF)
The composite endpoint included CV death and HHF. CV death included death due to myocardial infarction (MI), stroke, heart failure, sudden death, death during a CV procedure or as a result of procedure-related complications, or death due to other CV causes. For analytic purposes, undetermined causes of death were considered CV deaths. In determining whether a death event was CV in nature, the EAC took into consideration both the proximate and underlying causes. Adjudication of these events by the EAC was performed in a blinded fashion. Event rate estimated based on the time to the first occurrence of the composite endpoint of CV death and HHF are presented.
Measured: Up to 4.6 years
Major Adverse Cardiac Event (MACE)
The composite endpoint included CV death, non-fatal MI, and non-fatal stroke (that is, 3-point MACE). Adjudication of these events by the EAC was performed in a blinded fashion. Event rate estimated based on the time to the first occurrence of MACE are presented.
Measured: Up to 4.6 years
Hospitalized Heart Failure (HHF)
Adjudication of these events by the Endpoint Adjudication Committee (EAC) was performed in a blinded fashion. Event rate estimated based on the time to the first occurrence of hospitalized heart failure are presented.
Measured: Up to 4.6 years
Renal Composite Endpoint
The renal composite endpoint included composite of DoSC, ESKD and Renal death. DoSC: from the baseline average determination (sustained and confirmed by repeat central laboratory measure after at least 30 days and preferably within 60 days). ESKD: initiation of maintenance dialysis for at least 30 days, or renal transplantation, or an eGFR value of <15 mL/min/1.73 m^2 (sustained and confirmed by repeat central laboratory measure after at least 30 days and preferably within 60 days). Renal death: death in participants who have reached ESKD, died without initiating renal replacement therapy, and no other cause of death was determined via adjudication. Adjudication of these events by the EAC was performed in a blinded fashion. Event rate estimated based on the time to the first occurrence of the renal composite endpoint are presented.
Measured: Up to 4.6 years
Cardiovascular (CV) Death
CV death included death due to MI, stroke, heart failure, sudden death, death during a CV procedure or as a result of procedure-related complications, or death due to other CV causes. For analytic purposes, undetermined causes of death were considered CV deaths. In determining whether a death event was a CV in nature, the EAC took into consideration both the proximate and underlying causes. Adjudication of these events by the EAC was performed in a blinded fashion. Event rate estimated based on the time to the first occurrence of CV death are presented.
Measured: Up to 4.6 years
All-cause Mortality
Adjudication of these events by Endpoint Adjudication Committee (EAC) was performed in a blinded fashion. Event rate estimated based on time to first occurrence of all-cause mortality are presented.
Measured: Up to 4.6 years
CV Composite Endpoint
The CV composite endpoint included the CV death, non-fatal MI, non-fatal stroke, hospitalized heart failure, and hospitalized unstable angina. CV death included death due to MI, stroke, heart failure, sudden death, death during a CV procedure or as a result of procedure-related complications, or death due to other CV causes. For analytic purposes, undetermined causes of death were considered CV deaths. In determining whether a death event was a CV in nature, the EAC took into consideration both the proximate and underlying causes. Adjudication of these events by the EAC was performed in a blinded fashion. Event rate estimated based on the time to the first occurrence of the CV composite endpoint are presented.
Measured: Up to 4.6 years
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Feb 2014 (estimated)
- Study start17 Feb 2014
- Primary completion30 Oct 2018
- Study completion30 Oct 2018
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 (47)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 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 4,401 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
- NCT02065791
- Sponsor's protocol ID
- CR103517
- Other IDs
- 2013-004494-28, 28431754DNE3001
- Acronym
- CREDENCE
- Status last verified
- Dec 2019
- First submitted
- 17 Feb 2014
- Last updated
- 5 Dec 2019
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Li J, Gonzalez Villalobos RA, Rutkoski TJ, Farrington KP, Chipashvili V, Zheng G, Chen T, Yekkala K, Locatelli M, Zoja C, Benigni A, Lutnick B, Ho G, Reilly D, Zheng X, Zheng S, Bialecki R, Hansen MK, Wu H, Humphreys BD, Magnone MC, Myshkin E, Breyer MD. Vascular Endothelial Growth Factor Receptor 1-Blocking Antibody Improves Endothelial Structure, Kidney Function, and GFR in Diabetic Mice. J Am Soc Nephrol. 2026 Sep 1. doi: 10.1681/ASN.0000001176. Online ahead of print.
PubMed 42475421Moedt E, Koshino A, Jongs N, Ju W, Nair V, Kretzler M, Hansen MK, Arnott CG, Wheeler DC, Rossing P, Coca SG, Hammarstedt A, Greasley PJ, Bjornstad P, Bakker SJL, Heerspink HJL. Association of Urinary EGF with Kidney Outcomes and Effects of Sodium-Glucose Cotransporter 2 Inhibition. J Am Soc Nephrol. 2026 Apr 2. doi: 10.1681/ASN.0000001086. Online ahead of print.
PubMed 41926219Chiriaco M, Trico D, Giannoni A, Sacchetta L, Nesti L, Baldi S, Scozzaro T, Castiglione V, Natali A, Ferrannini E. Impact of canagliflozin on the cardiorenal effects of dietary sodium intake in type 2 diabetes: a post hoc analysis of the CREDENCE trial. Diabetologia. 2026 Jul;69(7):1806-1817. doi: 10.1007/s00125-026-06705-6. Epub 2026 Mar 12.
PubMed 41817689Heerspink 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 41198855Mottl A, Scott C, Green JB, Heerspink HJL, Mann JFE, McGill JB, Nangaku M, Rosenstock J, Rossing P, Li L, Li N, Vaduganathan M, Agarwal R; CONFIDENCE Trial Investigators. Baseline Kidney Function, Albuminuria, and Urine Albumin-Creatinine Ratio Reduction with Finerenone, Empagliflozin, or Both: Post Hoc Analyses of CONFIDENCE Trial. J Am Soc Nephrol. 2026 Apr 1;37(4):764-776. doi: 10.1681/ASN.0000000928. Epub 2025 Nov 6.
PubMed 41196655Bayes-Genis A, Cai A, Liu Y, Pandey A, Pop-Busui R, Hansen M, Januzzi JL. Impact of canagliflozin on heart stress and outcomes: Pooled insights from CREDENCE and CANVAS. Eur J Heart Fail. 2025 Dec;27(12):2887-2896. doi: 10.1002/ejhf.3786. Epub 2025 Jul 21.
PubMed 40689549Oshima M, Buizen L, Jongs N, Levin A, Chertow GM, Wheeler DC, Heerspink HJL, Arnott C, Jardine MJ, Mahaffey KW, Pollock C, Herrington WG, Perkovic V, Neuen BL. Sodium-Glucose Cotransporter 2 Inhibition and Hospitalizations in Patients with CKD: A Meta-Analysis of Kidney Outcome Trials. Clin J Am Soc Nephrol. 2025 Jul 14;20(9):1206-1214. doi: 10.2215/CJN.0000000771.
PubMed 40658498Jongs N, Gasparyan SB, Frison L, Schloemer P, Brinker M, Little DJ, Heerspink HJL. Use of eGFR Slope Thresholds as End Point Components in a Kidney Disease Progression Hierarchical Composite End Point. J Am Soc Nephrol. 2025 Dec 1;36(12):2421-2430. doi: 10.1681/ASN.0000000766. Epub 2025 Jun 17.
PubMed 40526444Januzzi 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 40105285Chatur S, Vaduganathan M, Fletcher RA, Perkovic V, Heerspink H, Arnott C, Pollock C, Mahaffey KW, Neal B, Jardine M, Solomon SD, Neuen BL. Canagliflozin reduces oral loop diuretic intensification in patients with type 2 diabetes: A participant-level pooled analysis of the CANVAS and CREDENCE trials. Eur J Heart Fail. 2025 Jun;27(6):994-1002. doi: 10.1002/ejhf.3586. Epub 2025 Jan 23.
PubMed 39844714Ferrannini E, Baldi S, Scozzaro MT, Ferrannini G, Hansen MK. Fasting substrates predict chronic kidney disease progression in CREDENCE trial patients with type 2 diabetes. JCI Insight. 2024 Dec 20;9(24):e180637. doi: 10.1172/jci.insight.180637.
PubMed 39704168Vaduganathan 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 38807510
Study at a glance
From the registry record, last updated by the sponsor on 5 Dec 2019. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized, Double-blind, Event-driven, Placebo-controlled, Multicenter Study of the Effects of Canagliflozin on Renal and Cardiovascular Outcomes in Subjects With Type 2 Diabetes Mellitus and Diabetic Nephropathy
- ClinicalTrials.gov ID
- NCT02065791
- Acronym / sponsor ID
- CREDENCE / CR103517
- Conditions
- Diabetes Mellitus, Type 2, Diabetic Nephropathy
- Keywords
- Diabetes Mellitus, Type 2, Diabetic Nephropathies, Canagliflozin, JNJ-28431754, End-Stage Kidney Disease, Chronic Kidney Disease, Macroalbuminuria
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 4,401 participants (actual)
- Lead sponsor
- Janssen Research & Development, LLCIndustry (pharma, biotech, devices)
- Collaborators
- The George Institute for Global Health, Australia
- Study start
- 17 Feb 2014 (actual)
- Primary completion
- 30 Oct 2018 (actual)
- Study completion
- 30 Oct 2018 (actual)
- First posted
- 19 Feb 2014 (estimated)
- Results
- Posted 20 Nov 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this study is to assess whether canagliflozin has a renal and vascular protective effect in reducing the progression of renal impairment relative to placebo in participants with type 2 diabetes mellitus (T2DM), Stage 2 or 3 chronic kidney disease (CKD) and macroalbuminuria, who are receiving standard of care including a maximum tolerated labeled daily dose of an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB).
Detailed description
This is a randomized (the study medication is assigned by chance), double-blind (neither physician nor participant knows the identity of the assigned treatment), placebo-controlled (an inactive substance that is compared with a medication to test whether the medication has a real effect), parallel-group, multicenter study of the effects of canagliflozin on renal and cardiovascular outcomes in participants with type 2 diabetes mellitus (T2DM) and diabetic nephropathy, who are receiving standard of care including a maximum tolerated daily dose of an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB).
The study will consist of a pretreatment phase (several weeks), and a double-blind treatment phase (up to approximately 66 months). During the pretreatment phase all participants will also receive diet/exercise counseling for lipid and blood pressure management as well as counseling on renal and cardiovascular (CV) risk factor medication. A post-treatment follow-up contact or visit will take place approximately 30 days after the last dose of study drug or the completion of the study. The total duration of the study is estimated to be about 5 to 5.5 years. Approximately 4,200 participants will be randomized in a 1:1 ratio to canagliflozin or matching placebo. Participants randomized to canagliflozin will receive a dose of 100 mg once daily. The overall safety and tolerability of canagliflozin will be evaluated by collecting information on adverse events, laboratory tests, vital signs (pulse, blood pressure), physical examination, and body weight.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Canagliflozin 100 mg | Experimental | Drug: CanagliflozinEach participant will receive 100 mg of canagliflozin once daily |
| Placebo | Placebo comparator | Drug: PlaceboEach participant will receive matching placebo once daily |
Who may qualify
- Ages
- 30 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- Type 2 diabetes mellitus with a hemoglobin A1c (HbA1c) greater than or equal to (>=) 6.5 percent (%) and less than or equal to (<=) 12.0%, with an estimated glomerular filtration rate (eGFR) of >= 30 milliliter (mL)/minute (min)/1.73meter (m)^2 and less than (<) 90 mL/min/1.73 m^2
- Participants need to be on a stable maximum tolerated labeled daily dose of an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) for at least 4 weeks prior to randomization
- Must have a urine albumin to creatinine ratio (UACR) of greater than (>) 300 milligram (mg)/gram (g) and <= 5000 mg/g
Key exclusion criteria (6 listed)
- History of diabetic ketoacidosis or type 1 diabetes mellitus
- History of hereditary glucose-galactose malabsorption or primary renal glucosuria
- Renal disease that required treatment with immunosuppressive therapy
- Known significant liver disease
- Current or history of New York Heart Association (NYHA) Class IV heart failure
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 |
|---|---|---|
| CanagliflozinOne 100 mg over-encapsulated tablet orally once daily | Drug | Canagliflozin 100 mg |
| PlaceboOne matching placebo capsule orally (by mouth) once daily | Drug | Placebo |
Primary outcome
Primary Composite Endpoint of Doubling of Serum Creatinine (DoSC), End-stage Kidney Disease (ESKD), and Renal or Cardiovascular (CV) Death
Time frame: Up to 4.6 years
Primary composite endpoint is the composite of DoSC, ESKD, and renal or CV death. DoSC: from baseline average determination (sustained and confirmed by repeat central laboratory measure after at least 30 days and preferably within 60 days). ESKD: as initiation of maintenance dialysis for at least 30 days, or renal transplantation, or an estimated glomerular filtration rate (eGFR) value of less than (<)15 milliliters per minute per 1.73 square meter (mL/min/1.73 m^2) (sustained and confirmed by repeat central laboratory measure after at least 30 days and preferably within 60 days). Renal death: death in participants who had reached ESKD, died without initiating renal replacement therapy, and no other cause of death was determined via adjudication. Adjudication of these events by Endpoint Adjudication Committee (EAC) was performed in blinded fashion. Event rate estimated based on time to first occurrence of primary composite endpoint are presented.
7 secondary outcomes
Composite Endpoint of CV Death and Hospitalized Heart Failure (HHF)
Time frame: Up to 4.6 years
Major Adverse Cardiac Event (MACE)
Time frame: Up to 4.6 years
Hospitalized Heart Failure (HHF)
Time frame: Up to 4.6 years
Renal Composite Endpoint
Time frame: Up to 4.6 years
Cardiovascular (CV) Death
Time frame: Up to 4.6 years
All-cause Mortality
Time frame: Up to 4.6 years
CV Composite Endpoint
Time frame: Up to 4.6 years
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 5 Dec 2019.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 42475421Li J, Gonzalez Villalobos RA, Rutkoski TJ, Farrington KP, Chipashvili V, Zheng G, Chen T, Yekkala K, Locatelli M, Zoja C, Benigni A, Lutnick B, Ho G, Reilly D, Zheng X, Zheng S, Bialecki R, Hansen MK, Wu H, Humphreys BD, Magnone MC, Myshkin E, Breyer MD. Vascular Endothelial Growth Factor Receptor 1-Blocking Antibody Improves Endothelial Structure, Kidney Function, and GFR in Diabetic Mice. J Am Soc Nephrol. 2026 Sep 1. doi: 10.1681/ASN.0000001176. Online ahead of print.
- Derived from this study: PubMed 41926219Moedt E, Koshino A, Jongs N, Ju W, Nair V, Kretzler M, Hansen MK, Arnott CG, Wheeler DC, Rossing P, Coca SG, Hammarstedt A, Greasley PJ, Bjornstad P, Bakker SJL, Heerspink HJL. Association of Urinary EGF with Kidney Outcomes and Effects of Sodium-Glucose Cotransporter 2 Inhibition. J Am Soc Nephrol. 2026 Apr 2. doi: 10.1681/ASN.0000001086. Online ahead of print.
- Derived from this study: PubMed 41817689Chiriaco M, Trico D, Giannoni A, Sacchetta L, Nesti L, Baldi S, Scozzaro T, Castiglione V, Natali A, Ferrannini E. Impact of canagliflozin on the cardiorenal effects of dietary sodium intake in type 2 diabetes: a post hoc analysis of the CREDENCE trial. Diabetologia. 2026 Jul;69(7):1806-1817. doi: 10.1007/s00125-026-06705-6. Epub 2026 Mar 12.
- 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 41196655Mottl A, Scott C, Green JB, Heerspink HJL, Mann JFE, McGill JB, Nangaku M, Rosenstock J, Rossing P, Li L, Li N, Vaduganathan M, Agarwal R; CONFIDENCE Trial Investigators. Baseline Kidney Function, Albuminuria, and Urine Albumin-Creatinine Ratio Reduction with Finerenone, Empagliflozin, or Both: Post Hoc Analyses of CONFIDENCE Trial. J Am Soc Nephrol. 2026 Apr 1;37(4):764-776. doi: 10.1681/ASN.0000000928. Epub 2025 Nov 6.
- Derived from this study: PubMed 40689549Bayes-Genis A, Cai A, Liu Y, Pandey A, Pop-Busui R, Hansen M, Januzzi JL. Impact of canagliflozin on heart stress and outcomes: Pooled insights from CREDENCE and CANVAS. Eur J Heart Fail. 2025 Dec;27(12):2887-2896. doi: 10.1002/ejhf.3786. Epub 2025 Jul 21.
- Derived from this study: PubMed 40658498Oshima M, Buizen L, Jongs N, Levin A, Chertow GM, Wheeler DC, Heerspink HJL, Arnott C, Jardine MJ, Mahaffey KW, Pollock C, Herrington WG, Perkovic V, Neuen BL. Sodium-Glucose Cotransporter 2 Inhibition and Hospitalizations in Patients with CKD: A Meta-Analysis of Kidney Outcome Trials. Clin J Am Soc Nephrol. 2025 Jul 14;20(9):1206-1214. doi: 10.2215/CJN.0000000771.
- Derived from this study: PubMed 40526444Jongs N, Gasparyan SB, Frison L, Schloemer P, Brinker M, Little DJ, Heerspink HJL. Use of eGFR Slope Thresholds as End Point Components in a Kidney Disease Progression Hierarchical Composite End Point. J Am Soc Nephrol. 2025 Dec 1;36(12):2421-2430. doi: 10.1681/ASN.0000000766. Epub 2025 Jun 17.
- 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 39844714Chatur S, Vaduganathan M, Fletcher RA, Perkovic V, Heerspink H, Arnott C, Pollock C, Mahaffey KW, Neal B, Jardine M, Solomon SD, Neuen BL. Canagliflozin reduces oral loop diuretic intensification in patients with type 2 diabetes: A participant-level pooled analysis of the CANVAS and CREDENCE trials. Eur J Heart Fail. 2025 Jun;27(6):994-1002. doi: 10.1002/ejhf.3586. Epub 2025 Jan 23.
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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
575 sites in 34 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Canagliflozin in people with Diabetes Mellitus, Type 2 and Diabetic Nephropathy, run by Janssen Research & Development, LLC at 575 sites in 34 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 3 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 5 Dec 2019. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 575 sites in United States, United Kingdom, Argentina, Japan, Brazil and 29 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
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 20 Nov 2019). 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?
Primary Composite Endpoint of Doubling of Serum Creatinine (DoSC), End-stage Kidney Disease (ESKD), and Renal or Cardiovascular (CV) Death (time frame: Up to 4.6 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 NCT02065791, which also lists 47 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 5 Dec 2019.