No Increased Risks of Stroke, Heart Failure With DPP-4i

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In short-term treatment duration, there was no increased risk of myocardial infarction stroke or heart failure using DPP-4i vs SU/TZD.
In short-term treatment duration, there was no increased risk of myocardial infarction stroke or heart failure using DPP-4i vs SU/TZD.

(HealthDay News) — For older US Medicare beneficiaries, dipeptidyl peptidase-4 inhibitors (DPP-4i) treatment is not associated with increased cardiovascular (CV) risk relative to sulfonylureas (SU) and thiazolidinediones (TZD), according to a study published online in Diabetes, Obesity and Metabolism.

Mugdha Gokhale, PhD, from the University of North Carolina at Chapel Hill, and colleagues identified two new-user cohorts of Medicare beneficiaries aged >65 years: DPP-4i versus SU (30,130 and 68,382 initiators, respectively) and DPP-4i versus TZD (20,596 and 13,526, respectively) during 2007 to 2013.

The researchers found that the hazard ratio for the composite outcome (myocardial infarction [MI], stroke, and all-cause mortality) was 0.75 (95% confidence interval [CI], 0.72 to 0.79) in the DPP-4i versus SU comparison. For DPP-4i and SU, respectively, the 1-year risks for MI were 1.00 (95% CI, 0.89 to 1.12) and 1.47 (95% CI, 1.38 to 1.56) per 100 patients; the corresponding numbers for stroke risk were 0.98 (95% CI, 0.87 to 1.10) and 1.09 (95% CI, 1.01 to 1.17). For DPP-4i versus TZD, the hazard ratio for the composite outcome was 0.94 (95% CI, 0.86 to 1.02). The 1-year risks for MI and stroke were about 0.90 and 0.80, respectively, per 100 patients for both DPP-4i and TZD.

"Though limited by the short treatment duration, our study suggests no increased short-term risk of MI stroke or heart failure with DPP-4i versus SU/TZD," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Reference

  1. Gokhale M, Buse JB, Jonsson Funk M, et al. No increased risk of cardiovascular events in older adults initiating dipeptidyl peptidase 4 inhibitors versus therapeutic alternatives. Diabetes Obes Metab. 14 February 2017. doi: 10.1111/dom.12906

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