TY - JOUR
T1 - Cardiovascular Safety of Dipeptidyl-Peptidase IV Inhibitors
T2 - A Meta-Analysis of Placebo-Controlled Randomized Trials
AU - Elgendy, Islam Y.
AU - Mahmoud, Ahmed N.
AU - Barakat, Amr F.
AU - Elgendy, Akram Y.
AU - Saad, Marwan
AU - Abuzaid, Ahmed
AU - Wayangankar, Siddarth A.
AU - Bavry, Anthony A.
N1 - Publisher Copyright:
© 2016, Springer International Publishing Switzerland.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Background: Large randomized trials have shown conflicting evidence regarding the cardiovascular safety of dipeptidyl-peptidase 4 (DPP-4) inhibitors. Systematic reviews have been limited by incomplete data and inclusion of observational studies. This study aimed to systematically evaluate the cardiovascular safety of DPP-4 inhibitors in patients with type 2 diabetes. Methods: Electronic databases were searched for randomized trials that compared DPP-4 inhibitors versus placebo and reported cardiovascular outcomes. The main outcome assessed in this analysis was heart failure. Other outcomes included all-cause mortality, cardiovascular mortality, myocardial infarction, and ischemic stroke. Summary odds ratios (ORs) were primarily constructed using Peto’s model. Results: A total of 90 trials with 66,730 patients were included. Compared with placebo, DPP-4 inhibitors were associated with a non-significant increased risk of heart failure [OR 1.11, 95% confidence interval (CI) 0.99–1.25, P = 0.07] at a mean of 108 weeks. The risk of all-cause mortality (OR 1.03, 95% CI 0.94–1.12, P = 0.53), cardiovascular mortality (OR 1.02, 95% CI 0.92–1.14, P = 0.72), myocardial infarction (OR 0.98, 95% CI 0.88–1.09, P = 0.69), and ischemic stroke (OR 0.99, 95% CI 0.85–1.15, P = 0.92) was similar between both groups. Conclusion: In patients with type 2 diabetes, the safety profile of DPP-4 inhibitors is similar to placebo. As a class, there is only weak evidence for an increased risk of heart failure.
AB - Background: Large randomized trials have shown conflicting evidence regarding the cardiovascular safety of dipeptidyl-peptidase 4 (DPP-4) inhibitors. Systematic reviews have been limited by incomplete data and inclusion of observational studies. This study aimed to systematically evaluate the cardiovascular safety of DPP-4 inhibitors in patients with type 2 diabetes. Methods: Electronic databases were searched for randomized trials that compared DPP-4 inhibitors versus placebo and reported cardiovascular outcomes. The main outcome assessed in this analysis was heart failure. Other outcomes included all-cause mortality, cardiovascular mortality, myocardial infarction, and ischemic stroke. Summary odds ratios (ORs) were primarily constructed using Peto’s model. Results: A total of 90 trials with 66,730 patients were included. Compared with placebo, DPP-4 inhibitors were associated with a non-significant increased risk of heart failure [OR 1.11, 95% confidence interval (CI) 0.99–1.25, P = 0.07] at a mean of 108 weeks. The risk of all-cause mortality (OR 1.03, 95% CI 0.94–1.12, P = 0.53), cardiovascular mortality (OR 1.02, 95% CI 0.92–1.14, P = 0.72), myocardial infarction (OR 0.98, 95% CI 0.88–1.09, P = 0.69), and ischemic stroke (OR 0.99, 95% CI 0.85–1.15, P = 0.92) was similar between both groups. Conclusion: In patients with type 2 diabetes, the safety profile of DPP-4 inhibitors is similar to placebo. As a class, there is only weak evidence for an increased risk of heart failure.
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U2 - 10.1007/s40256-016-0208-x
DO - 10.1007/s40256-016-0208-x
M3 - Article
C2 - 27873238
AN - SCOPUS:84996541796
SN - 1175-3277
VL - 17
SP - 143
EP - 155
JO - American Journal of Cardiovascular Drugs
JF - American Journal of Cardiovascular Drugs
IS - 2
ER -