scholarly journals Cardiovascular safety signals with dipeptidyl peptidase-4 inhibitors: A disproportionality analysis among high-risk patients

2018 ◽  
Vol 27 (6) ◽  
pp. 660-667 ◽  
Author(s):  
Sheriza N. Baksh ◽  
Mara McAdams-DeMarco ◽  
Jodi B. Segal ◽  
G. Caleb Alexander
Keyword(s):  
High Risk ◽  
Dipeptidyl Peptidase ◽  
Cardiovascular Safety ◽  
Disproportionality Analysis ◽  
Dipeptidyl Peptidase 4 ◽  
High Risk Patients ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Risk Patients ◽  
Safety Signals

scholarly journals Dipeptidyl peptidase-4 inhibitor cardiovascular safety in patients with type 2 diabetes, with cardiovascular and renal disease: a retrospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sheriza Baksh ◽  
Jiajun Wen ◽  
Omar Mansour ◽  
Hsien-Yen Chang ◽  
Mara McAdams-DeMarco ◽  
...  
Keyword(s):  
High Risk ◽  
Renal Impairment ◽  
Renal Disease ◽  
Lower Risk ◽  
Retrospective Cohort ◽  
Dipeptidyl Peptidase ◽  
Cardiovascular Safety ◽  
High Risk Patients ◽  
Risk Patients ◽  
Similar Risk

AbstractClinical trials investigating cardiovascular safety of dipeptidyl peptidase-IV inhibitors (DPP-4i) among patients with cardiovascular and renal disease rarely recruit patients with renal impairment, despite associations with increased risk for major adverse cardiovascular events (MACE). We investigated the risk of MACE associated with the use of DPP-4i among these high-risk patients. Using a new-user, retrospective, cohort design, we analyzed 2010–2015 IBM MarketScan Commercial Claims and Encounters for patients with diabetes, comorbid with cardiovascular disease and/or renal impairment. We compared time to first MACE for DPP-4i versus sulfonylurea and versus metformin. Of 113,296 individuals, 9146 (8.07%) were new DPP-4i users, 17,481 (15.43%) were new sulfonylurea users, and 88,596 (78.20%) were new metformin users. Exposure groups were not mutually exclusive. DPP-4i was associated with lower risk for MACE than sulfonylurea (aHR 0.84; 95% CI 0.74, 0.93) and similar risk for MACE to metformin (aHR 1.07; 95% CI [1.04, 1.16]). DPP-4i use was associated with lower risk for MACE compared to sulfonylureas and similar risk for MACE compared to metformin. This association was most evident in the first year of therapy, suggesting that DPP-4i is a safer choice than sulfonylurea for diabetes treatment initiation in high-risk patients.

scholarly journals Impact of Dipeptidyl Peptidase-4 Inhibitors on Glycemic Control and Cardiovascular Safety with Adherence: An Overview

2019 ◽  
Vol 25 (3-4) ◽  
pp. 90-99
Author(s):  
Keerthanaa Bhavadasan ◽  
Ann Merry Davis ◽  
Bharathi Kolanthavel
Keyword(s):  
Glycemic Control ◽  
Lifestyle Modification ◽  
Glucagon Secretion ◽  
Dipeptidyl Peptidase ◽  
Major Adverse Cardiovascular Events ◽  
Tolerability Profile ◽  
Cardiovascular Safety ◽  
Glucose Lowering ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors

Diabetes is a ubiquitous chronic disease worldwide. The prevalence is expected to increase further to 9.9% by the year 2045. Dipeptidyl peptidase-4 (DPP-4) inhibitors, also called as gliptins, act as incretin enhancers. They inhibit glucagon secretion and arouse postprandial insulin secretion, both in a glucose-dependent mode. In 2006, sitagliptin was approved as a first DPP-4 inhibitor in the treatment of diabetes concurrently with lifestyle modification. Sitagliptin has a high bioavailability, while linagliptin has a safety and tolerability profile similar to that of placebo, with a very low risk for hypoglycemia. DPP-4 inhibitors have a weight neutrality effect. One major benefit of gliptins is their excellent tolerability/safety profile compared with other glucose-lowering medications, including other new glucose-lowering agents such as sodium/glucose cotransporter 2 inhibitors. Compared with sulfonylureas, they have a smaller decline in HbA1c. The three gliptins showed excellent effect on glycemic control as an add-on therapy in treating type 2 diabetes. The major adverse cardiovascular events, malignancy and pancreatitis, were not associated with the treatment with sitagliptin, a DPP-4 inhibitor. The objective of establishing cardiovascular safety trials such as SAVOR-TIMI 53, EXAMINE, TECOS, CAROLINA, and CARMELINA. DPP-4 inhibitors have higher rates of adherence and persistence compared with sulfonylureas and thiazolidinediones.

Combination of norfloxacin and cisapride in prevention of SBP in high risk patients: A new approach

2001 ◽  
Vol 120 (5) ◽  
pp. A376-A376
Author(s):  
B JEETSANDHU ◽  
R JAIN ◽  
J SINGH ◽  
M JAIN ◽  
J SHARMA ◽  
...  
Keyword(s):  
High Risk ◽  
New Approach ◽  
High Risk Patients ◽  
Risk Patients
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