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Cardiovascular safety outcomes of new antidiabetic therapies.

American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists
January 1, 1970
Marlys H LeBras et al. (3 authors)
Journal ArticleReviewHuman Study
Extracted Claims (23)
InterventionDirectionEndpointPopulationDosageImpactClaim #
DPP-4 inhibitor
no change
cardiovascular events
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
showed a neutral effect
#1
lixisenatide
no change
cardiovascular events
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
showed a neutral effect
#2
empagliflozin
decrease
cardiovascular events
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
showed a significant reduction
#3
empagliflozin
decrease
cardiovascular death
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
showed a significant reduction
#4
empagliflozin
decrease
all-cause death
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
showed a significant reduction
#5
empagliflozin
decrease
hospitalization due to heart failure
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
showed a significant reduction
#6
liraglutide
decrease
cardiovascular events
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
reduced
#7
liraglutide
decrease
cardiovascular death
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
reduced
#8
liraglutide
decrease
all-cause death
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
reduced
#9
semaglutide
decrease
cardiovascular events
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
reduced
#10
semaglutide
decrease
nonfatal stroke
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
reduced
#11
Most studies
no change
hospitalization for HF
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
showed a neutral effect
#12
saxagliptin
increase
hospitalizations for HF
subgroups of patients without a history of HF
-
showed a significant increase
#13
alogliptin
increase
hospitalizations for HF
subgroups of patients without a history of HF
-
showed a significant increase
#14
empagliflozin
decrease
hospitalizations for HF
patients with type 2 diabetes mellitus with or at risk for cardiovascular disease
-
showed a significant reduction
#15
saxagliptin
increase
hospitalization for HF
-
-
were associated with an increase
#16
alogliptin
increase
hospitalization for HF
-
-
were associated with an increase
#17
empagliflozin
decrease
cardiovascular events and death
-
-
showed a reduction
#18
liraglutide
decrease
cardiovascular events and death
-
-
showed a reduction
#19
semaglutide
decrease
cardiovascular events and death
-
-
showed a reduction
#20
empagliflozin
no change
cardiovascular endpoints
-
-
showed a neutral effect
#21
liraglutide
no change
cardiovascular endpoints
-
-
showed a neutral effect
#22
semaglutide
no change
cardiovascular endpoints
-
-
showed a neutral effect
#23
Abstract

PURPOSE: The cardiovascular safety outcomes of newer antidiabetic agents were reviewed. SUMMARY: Seven randomized, placebo-controlled trials involving patients with type 2 diabetes mellitus with or at risk for cardiovascular disease were reviewed. The trials examined the cardiovascular safety outcomes of the following agents: alogliptin, saxagliptin, and sitagliptin (dipeptidyl peptidase-4 [DPP-4] inhibitors); liraglutide, lixisenatide, and semaglutide (glucagon-like peptide-1 agonists); and empagliflozin (a sodium glucose cotransport-2 inhibitor). The DPP-4 inhibitor and lixisenatide trials showed a neutral effect on cardiovascular events (composite of cardiovascular death, myocardial infarction, or stroke, with or without unstable angina). Empagliflozin showed a significant reduction in cardiovascular events, cardiovascular death, all-cause death, and hospitalization due to heart failure (HF); liraglutide reduced cardiovascular events, cardiovascular death, and all-cause death, and semaglutide reduced cardiovascular events and nonfatal stroke. Most studies showed a neutral effect of the drug on hospitalization for HF; however, saxagliptin and alogliptin (in the subgroups of patients without a history of HF) showed a significant increase while empagliflozin showed a significant reduction in hospitalizations for HF. The data for empagliflozin, liraglutide, and semaglutide are compelling; however, further studies are necessary to confirm observed benefits and better characterize long-term safety and their use as a strategy to reduce cardiovascular events. CONCLUSION: A review of cardiovascular safety outcomes for new antidiabetic agents found that saxagliptin and alogliptin were associated with an increase in hospitalization for HF. The data for empagliflozin, liraglutide, and semaglutide showed a reduction in cardiovascular events and death or a neutral effect on cardiovascular endpoints.

Medical Subject Headings (MeSH)
AnimalsCardiovascular DiseasesDiabetes Mellitus, Type 2Dipeptidyl-Peptidase IV InhibitorsGlucagon-Like Peptide 1HumansHypoglycemic AgentsRandomized Controlled Trials as TopicSodium-Glucose Transporter 2 InhibitorsTreatment Outcome
Study Links
PubMed ID28483748
Related Supplements
Cardiovascular safety outcomes of new antidiabetic therapies... | Panacea Index