Sitagliptin OK for Older Type 2 Diabetes Patients With CVD
Sitagliptin did not significantly impact the primary composite, death, heart failure hospitalization, severe hypoglycemia, rates of acute pancreatitis and pancreatic cancer, or serious adverse events
(HealthDay News) — Sitagliptin has a neutral effect on cardiovascular risk among older patients with type 2 diabetes, according to a study published online in Diabetes Care.
M Angelyn Bethel, MD, from the Oxford Center for Diabetes in the United Kingdom, and colleagues analyzed baseline characteristics and clinical outcomes for Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS) participants with type 2 diabetes and cardiovascular disease. 14% of the 14,351 participants with age recorded were aged ≥75 years.
The researchers found that older participants had significantly higher rates of the primary composite outcome (6.46 vs 3.67 events per 100 person-years; hazard ratio [HR], 1.72; 95% confidence interval [CI], 1.52 to 1.94), death (HR, 2.52; 95% CI, 2.20 to 2.89), severe hypoglycemia (HR, 1.53; 95% CI, 1.15 to 2.03), and fractures (HR, 1.84; 95% CI, 1.44 to 2.35) during 2.9 years of median follow-up. Sitagliptin did not significantly impact the primary composite outcome in the older cohort (HR, 1.10; 95% CI, 0.89 to 1.36), nor did it impact death (HR, 1.05 [95% CI, 0.83 to 1.32), heart failure hospitalization (HR, 0.99; 95% CI, 0.65 to 1.49), or severe hypoglycemia (HR, 1.03; 95% CI, 0.62 to 1.71).
"Among older patients with well-controlled type 2 diabetes and cardiovascular disease, sitagliptin had neutral effects on cardiovascular risk and raised no significant safety concerns," the authors write.
Several authors disclosed financial ties to pharmaceutical companies, including Merck, which manufactures sitagliptin and funded the TECOS trial.
- Bethel MA, Engel SS, Green JB, et al. Assessing the Safety of Sitagliptin in Older Participants in the Trial Evaluating Cardiovascular Outcomes With Sitagliptin (TECOS). Diabetes Care. 5 January 2017. doi: 10.2337/dc16-1135.