Is the Risk of Hospitalized Heart Failure Greater with DPP-4 Inhibitors?

saxagliptin, sitagliptin versus other antihyperglycemic agents showed no difference
saxagliptin, sitagliptin versus other antihyperglycemic agents showed no difference

HealthDay News — Use of saxagliptin or sitagliptin is not associated with increased risk of hospitalized heart failure (hHF) compared with other antihyperglycemic agents, according to a study published online April 26 in the Annals of Internal Medicine.

Sengwee Toh, ScD, from Harvard Medical School and the Harvard Pilgrim Health Care Institute in Boston, and colleagues examined the correlations of hHF with saxagliptin and sitagliptin in a retrospective new-user cohort study. Data were included for 18 health insurance and health system data partners in the U.S. Food and Drug Administration's Mini-Sentinel program (78,553 saxagliptin users and 298,124 sitagliptin users).

The researchers found that the risk for hHF was not higher for dipeptidyl peptidase-4 inhibitors versus other drugs. From the disease risk score (DRS)-stratified analyses, the hazard ratios were 0.83, 0.63, 0.69, and 0.61 for saxagliptin versus sitagliptin, pioglitazone, sulfonylureas, and insulin, respectively. In the DRS-stratified analyses, the hazard ratios were 0.74, 0.86, and 0.71 for sitagliptin versus pioglitazone, sulfonylureas, and insulin, respectively. Similar results were seen from the 1:1 propensity score-matched analyses, in subgroup analyses of patients with and without prior cardiovascular disease, and in a subgroup defined by the two highest DRS deciles.

"In this large cohort study, a higher risk for hHF was not observed in users of saxagliptin or sitagliptin compared with other selected antihyperglycemic agents," the authors write.

One author disclosed financial ties to Novartis Pharmaceuticals.

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