Safety of dipeptidyl peptidase-4 inhibitors for treating type 2 diabetes.

Abstract

INTRODUCTION:

Dipeptidyl peptidase-4 (DPP-4) inhibitors (gliptins) occupy a growing place in the armamentarium of drugs used for the management of hyperglycemia in type 2 diabetes, although some safety concerns have been raised in recent years.

AREAS COVERED:

An updated review providing an analysis of available safety data (meta-analyses, randomized controlled trials, observational cohort and case-control studies and pharmacovigilance reports) with five commercialized DPP-4 inhibitors (sitagliptin, vildagliptin, saxagliptin, alogliptin, linagliptin). A special focus is given to overall safety profile; pancreatic adverse events (AEs) (acute pancreatitis, pancreatic cancer); overall cardiovascular safety (myocardial infarction and stroke); congestive heart failure concern and finally, safety in special populations (elderly, renal impairment).

EXPERT OPINION:

The good tolerance/safety profile of DPP-4 inhibitors has been largely confirmed, including in more fragile populations (elderly, renal impairment) with almost no increased risk of infection or gastrointestinal AEs, no weight gain and a minimal risk of hypoglycemia. Although an increased risk of acute pancreatitis and pancreatic cancer was suspected, the complete set of available data appears reassuring so far. Cardiovascular safety of DPP-4 inhibitors has been proven but an unexpected increased risk of heart failure has been reported which should be confirmed in ongoing trials and better understood. Further postmarketing surveillance is recommended.

• Authors: André J Scheen
• Journal: Expert opinion on drug safety (Expert Opin Drug Saf) Vol. 14 Issue 4 Pg. 505-24 (Apr 2015) ISSN: 1744-764X [Electronic] England
• PMID: 25630605 (Publication Type: Journal Article, Review)

Chemical References

• Dipeptidyl-Peptidase IV Inhibitors
• Hypoglycemic Agents

Topics

• Diabetes Mellitus, Type 2 (drug therapy)
• Dipeptidyl-Peptidase IV Inhibitors (adverse effects, therapeutic use)
• Humans
• Hyperglycemia (drug therapy, etiology)
• Hypoglycemia (chemically induced, epidemiology)
• Hypoglycemic Agents (adverse effects, therapeutic use)