You may be slightly bored hearing about cardiovascular outcomes trials by now, but I still find them fascinating and think they're worth discussing.
DPP-4 Inhibitors and Congestive Heart Failure
In terms of the dipeptidyl peptidase-4 (DPP-4) cardiovascular outcomes trials, none of them have shown a cardiovascular benefit, and they seemed pretty neutral to me. However, when we received the results of the SAVOR-TIMI trial, there was an increased risk for congestive heart failure (CHF) in patients who were treated with saxagliptin.[1]
This was a concern, and there is now a warning from the US Food and Drug Administration (FDA) on the label of the DPP-4 inhibitors saying that saxagliptin can increase the risk for CHF.
I have not really seen this in my own practice, and I've always felt that the DPP-4 inhibitors were pretty safe for patients who were more frail or perhaps at more risk for CHF. DPP-4 inhibitors don't cause hypoglycemia and they're easy to use.
There was absolutely no difference between linagliptin and placebo in terms of heart failure hospitalizations.
The CARMELINA trial, which included patients with type 2 diabetes who were treated with linagliptinshowed that there was not only no particular benefit but also no risk for an increased rate of CHF.
COMMENTARY
Cardiovascular Outcomes Trials Give 'Comforting' Results
Anne L. Peters, MD
DisclosuresDecember 13, 2018
You may be slightly bored hearing about cardiovascular outcomes trials by now, but I still find them fascinating and think they're worth discussing.
DPP-4 Inhibitors and Congestive Heart Failure
In terms of the dipeptidyl peptidase-4 (DPP-4) cardiovascular outcomes trials, none of them have shown a cardiovascular benefit, and they seemed pretty neutral to me. However, when we received the results of the SAVOR-TIMI trial, there was an increased risk for congestive heart failure (CHF) in patients who were treated with saxagliptin.[1]
This was a concern, and there is now a warning from the US Food and Drug Administration (FDA) on the label of the DPP-4 inhibitors saying that saxagliptin can increase the risk for CHF.
I have not really seen this in my own practice, and I've always felt that the DPP-4 inhibitors were pretty safe for patients who were more frail or perhaps at more risk for CHF. DPP-4 inhibitors don't cause hypoglycemia and they're easy to use.
The CARMELINA trial, which included patients with type 2 diabetes who were treated with linagliptinshowed that there was not only no particular benefit but also no risk for an increased rate of CHF.
Medscape Diabetes © 2018 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Anne L. Peters. Cardiovascular Outcomes Trials Give 'Comforting' Results - Medscape - Dec 13, 2018.
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Authors and Disclosures
Authors and Disclosures
Author(s)
Anne L. Peters, MD
Professor, Keck School of Medicine; Director, University of Southern California Westside Center for Diabetes, University of Southern California, Los Angeles, California
Disclosure: Anne L. Peters, MD, has disclosed the following relevant financial relationships:
Serve(d) on the advisory board for: Abbott Diabetes Care; Becton Dickinson; Bigfoot Biomedical; Boehringer Ingelheim Pharmaceuticals, Inc.; Eli Lilly and Company; Lexicon Pharmaceuticals, Inc.; Livongo; Medscape; Merck & Co., Inc.; Novo Nordisk; Omada Health; sanofi-aventis; Science 37
Received research support from: Dexcom; MannKind Corporation
Serve(d) as a member of a speakers bureau for: Novo Nordisk