Pooled patient level data are better suited than study level data to investigate the link between dipeptidyl peptidase-4 inhibitors and the risk of heart failure in type 2 diabetes

BMJ ◽  
2016 ◽  
pp. i2920
Author(s):  
Tejas Patel ◽  
Bereket Tesfaldet ◽  
Charu Gandotra
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Dipeptidyl Peptidase ◽  
Patient Level Data ◽  
Dipeptidyl Peptidase 4 ◽  
Patient Level ◽  
Level Data ◽  
Dipeptidyl Peptidase 4 Inhibitors

scholarly journals Dipeptidyl peptidase-4 inhibitors and cardiovascular and renal disease in type 2 diabetes: What have we learned from the CARMELINA trial?

2019 ◽  
Vol 16 (4) ◽  
pp. 303-309 ◽  
Author(s):  
Nordin MJ Hanssen ◽  
Karin AM Jandeleit-Dahm
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Side Effect ◽  
Dipeptidyl Peptidase ◽  
Safe Alternative ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Favourable Safety ◽  
Favourable Safety Profile

Dipeptidyl peptidase-4 inhibitors are a relatively new class of oral anti-hyperglycaemic drugs to treat type 2 diabetes through prevention of degradation of incretins by the dipeptidyl peptidase-4 enzyme. The large trials evaluating the dipeptidyl peptidase-4 inhibitors sitagliptin, alogliptin and saxagliptin demonstrated safety for cardiovascular disease. Post hoc analyses on renal endpoints yielded similar findings. Linagliptin is the latest dipeptidyl peptidase-4 inhibitor evaluated in the CARMELINA trial. CARMELINA included individuals with type 2 diabetes and high cardiovascular and renal risk. Even in this setting, linagliptin displayed cardiovascular safety. CARMELINA also removed initial concerns for heart failure as a class-specific side-effect of dipeptidyl peptidase-4 inhibitors, as no signal for heart failure was found. Although numerically low, CARMELINA did confirm increased rates of pancreatitis in the linagliptin group, suggesting that pancreatitis is a class-specific side-effect of dipeptidyl peptidase-4 inhibitors. Linagliptin reduced progression of albuminuria, but had no effect on other hard renal endpoints. Overall, dipeptidyl peptidase-4 inhibitors are safe but do not confer significant reductions in complications observed for some of the other new glucose-lowering drugs. However, linagliptin is a safe alternative in renal impairment, without dose adjustment. Furthermore, dipeptidyl peptidase-4 inhibitors may hold value as alternatives to sulfonyl-urea derivatives or as an add-on therapy to delay insulin prescription given their favourable safety profile.

scholarly journals Association Between Hospitalization for Heart Failure and Dipeptidyl Peptidase 4 Inhibitors in Patients With Type 2 Diabetes: An Observational Study

Diabetes Care ◽  
2016 ◽  
Vol 39 (5) ◽  
pp. 726-734 ◽  
Author(s):  
Alex Z. Fu ◽  
Stephen S. Johnston ◽  
Ameen Ghannam ◽  
Katherine Tsai ◽  
Katherine Cappell ◽  
...  
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Observational Study ◽  
Dipeptidyl Peptidase ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors
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