{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T07:11:28Z","timestamp":1782371488530,"version":"3.54.5"},"reference-count":44,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,11,8]],"date-time":"2019-11-08T00:00:00Z","timestamp":1573171200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:p>The CANVAS program detected a 2-fold increased risk of lower limb amputation in patients treated with canagliflozin compared with those with placebo. This adverse effect was not confirmed in the CREDENCE trial. Moreover, randomized controlled trials with other agents in this class, dapagliflozin and empagliflozin, did not detect increased risk of amputation. Observational studies, cohort studies, and pharmacovigilance reports with sodium-glucose cotransporter 2 inhibitor (SGLT2i) have reported conflicting results. Whether this adverse event is a drug effect specific to canagliflozin, or a SGLT2i class effect, remains controversial. Until more evidence emerges, clinicians should avoid using SGLT2i, especially canagliflozin, in patients with previous amputations or existing foot ulceration.<\/jats:p>","DOI":"10.1177\/1534734619878090","type":"journal-article","created":{"date-parts":[[2019,11,8]],"date-time":"2019-11-08T11:46:04Z","timestamp":1573213564000},"page":"21-26","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Canagliflozin and Amputation Risk: Evidence So Far"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0053-5000","authenticated-orcid":false,"given":"Eleni","family":"Papadokostaki","sequence":"first","affiliation":[{"name":"General Hospital of Heraklion Venizeleio-Pananeio, Heraklion, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Rizos","sequence":"additional","affiliation":[{"name":"European University Cyprus, Nicosia, Cyprus"},{"name":"University of Ioannina, Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7325-8983","authenticated-orcid":false,"given":"Stelios","family":"Tigas","sequence":"additional","affiliation":[{"name":"University of Ioannina, Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos N.","family":"Liberopoulos","sequence":"additional","affiliation":[{"name":"University of Ioannina, Ioannina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,11,8]]},"reference":[{"key":"bibr1-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67698-2"},{"key":"bibr2-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1177\/1534734610371600"},{"key":"bibr3-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1177\/1534734617699318"},{"key":"bibr4-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1177\/1534734615592313"},{"key":"bibr5-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2015.10.005"},{"key":"bibr6-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-018-4663-6"},{"key":"bibr7-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32590-X"},{"key":"bibr8-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611925"},{"key":"bibr9-1534734619878090","unstructured":"US Food and Drug Administration. FDA Drug Safety Communication: FDA confirms increased risk of leg and foot amputations with the diabetes medicine canagliflozin (Invokana, Invokamet, Invokamet XR). https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-drug-safety-communication-fda-confirms-increased-risk-leg-and-foot-amputations-diabetes-medicine. Published July 13, 2017. Accessed May 5, 2019."},{"key":"bibr10-1534734619878090","unstructured":"European Medicines Agency. SGLT2 inhibitors (previously canagliflozin). https:\/\/www.ema.europa.eu\/en\/medicines\/human\/referrals\/sglt2-inhibitors-previously-canagliflozin. Accessed May 5, 2019."},{"key":"bibr11-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-018-0001-9"},{"key":"bibr12-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-019-4839-8"},{"key":"bibr13-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13115"},{"key":"bibr14-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1811744"},{"key":"bibr15-1534734619878090","doi-asserted-by":"publisher","DOI":"10.2337\/dc07-2244"},{"key":"bibr16-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504720"},{"key":"bibr17-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.032031"},{"key":"bibr18-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-017-0573-0"},{"key":"bibr19-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1812389"},{"key":"bibr20-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13124"},{"key":"bibr21-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabet.2018.02.001"},{"key":"bibr22-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-022577"},{"key":"bibr23-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13648"},{"key":"bibr24-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.031227"},{"key":"bibr25-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.3034"},{"key":"bibr26-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13459"},{"key":"bibr27-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13477"},{"key":"bibr28-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13647"},{"key":"bibr29-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13424"},{"key":"bibr30-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.k4365"},{"key":"bibr31-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30257-7"},{"key":"bibr32-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1111\/dom.13255"},{"key":"bibr33-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2018.06.004"},{"key":"bibr34-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2016-314704"},{"key":"bibr35-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-017-0611-x"},{"key":"bibr36-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1002\/pds.932"},{"key":"bibr37-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000001054"},{"key":"bibr38-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-019-4835-z"},{"key":"bibr39-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1326.2011.01517.x"},{"key":"bibr40-1534734619878090","doi-asserted-by":"publisher","DOI":"10.2337\/db16-0058"},{"key":"bibr41-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2019.04.008"},{"key":"bibr42-1534734619878090","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2019.00362"},{"key":"bibr43-1534734619878090","doi-asserted-by":"publisher","DOI":"10.31083\/j.rcm.2018.02.021"},{"key":"bibr44-1534734619878090","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2018.12.006"}],"container-title":["The International Journal of Lower Extremity Wounds"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1534734619878090","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1534734619878090","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1534734619878090","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:04:18Z","timestamp":1777457058000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1534734619878090"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,8]]},"references-count":44,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1177\/1534734619878090"],"URL":"https:\/\/doi.org\/10.1177\/1534734619878090","relation":{},"ISSN":["1534-7346","1552-6941"],"issn-type":[{"value":"1534-7346","type":"print"},{"value":"1552-6941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,8]]}}}