Abstract | INTRODUCTION: Regulatory requirements mandate that new drugs for treatment of patients with type 2 diabetes mellitus (T2DM), such as dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists, are evaluated to show that they do not increase cardiovascular (CV) risk. METHODS: RESULTS: Thirty-six articles met the inclusion criteria encompassing 11 pooled analyses, 17 meta-analyses, and eight RCTs (including secondary analyses). Over the short term (up to 4 years), patients with T2DM exposed to a DPP-4 inhibitor or GLP-1 receptor agonist were not at increased risk for MACE (or its component endpoints) compared with those who received comparator agents. Two meta-analyses showed a significant reduction in the incidence of MACE associated with DPP-4 inhibitor therapy as a drug class, but this beneficial effect was not observed in other meta-analyses that included large RCT CV outcome studies. In four RCTs that evaluated alogliptin, saxagliptin, sitagliptin, or lixisenatide, there was no overall increased risk for MACE relative to placebo in T2DM patients at high risk for CV events or with established CV disease, although there was an increased rate of hospitalization for heart failure associated with saxagliptin. A fifth RCT showed that liraglutide reduced MACE risk by 13% versus placebo. CONCLUSION:
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Authors | Edoardo Mannucci, Matteo Monami |
Journal | Advances in therapy
(Adv Ther)
Vol. 34
Issue 1
Pg. 1-40
(01 2017)
ISSN: 1865-8652 [Electronic] United States |
PMID | 27844335
(Publication Type: Journal Article, Review, Systematic Review)
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Chemical References |
- Dipeptides
- Dipeptidyl-Peptidase IV Inhibitors
- Glucagon-Like Peptide-1 Receptor
- Hypoglycemic Agents
- Incretins
- Peptides
- Piperidines
- Uracil
- lixisenatide
- saxagliptin
- alogliptin
- Adamantane
- Sitagliptin Phosphate
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Topics |
- Adamantane
(analogs & derivatives, therapeutic use)
- Cardiovascular Diseases
(epidemiology)
- Diabetes Mellitus, Type 2
(drug therapy, epidemiology)
- Dipeptides
(therapeutic use)
- Dipeptidyl-Peptidase IV Inhibitors
(adverse effects, therapeutic use)
- Glucagon-Like Peptide-1 Receptor
(antagonists & inhibitors)
- Humans
- Hypoglycemic Agents
(adverse effects, therapeutic use)
- Incretins
(adverse effects, therapeutic use)
- Meta-Analysis as Topic
- Peptides
(therapeutic use)
- Piperidines
(therapeutic use)
- Randomized Controlled Trials as Topic
- Sitagliptin Phosphate
(therapeutic use)
- Uracil
(analogs & derivatives, therapeutic use)
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