For patients with type 2 diabetes, treatment with the dipeptidyl peptidase 4 (DPP-4) inhibitors saxagliptin or alogliptin is not associated with improvements in cardiovascular risk, according to two studies published online Sept. 2 in the New England Journal of Medicine to coincide with presentation at the annual European Society of Cardiology Congress, held from Aug. 31 to Sept. 4 in Amsterdam.
Benjamin M. Scirica, M.D., M.P.H., from Brigham and Women’s Hospital in Boston, and colleagues randomized 16,492 patients with type 2 diabetes with a history of, or at risk for, cardiovascular events to receive saxagliptin or placebo. The primary end point was a composite of cardiovascular death, myocardial infarction, or ischemic stroke. During a median follow-up of 2.1 years, the researchers found that the primary end point event occurred in 7.3 percent of participants in the saxagliptin group and 7.2 percent of participants in the placebo group.
William B. White, M.D., from the University of Connecticut School of Medicine in Farmington, and colleagues randomized 5,380 patients with type 2 diabetes and either an acute myocardial infarction or unstable angina requiring hospitalization to receive alogliptin or placebo in addition to existing antihyperglycemic and cardiovascular drug therapy.
The primary end point was a composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. The researchers found that the primary end point occurred in 11.3 percent of patients assigned to alogliptin and 11.8 percent assigned to placebo.
“In conclusion, among patients with type 2 diabetes and a recent acute coronary syndrome, treatment with alogliptin resulted in rates of death from cardiovascular causes, nonfatal myocardial infarction, and nonfatal stroke that were similar to those with placebo,” White and colleagues write.
The Scirica study was funded by AstraZeneca and Bristol-Myers Squibb. The White study was funded by Takeda Development.