scholarly journals Impact of metformin use on the cardiovascular effects of dipeptidyl peptidase‐4 inhibitors: An analysis of Medicare claims data from 2007 to 2015

2019 ◽  
Vol 21 (4) ◽  
pp. 854-865 ◽  
Author(s):  
Matthew J. Crowley ◽  
Mugdha Gokhale ◽  
Virginia Pate ◽  
Til Stürmer ◽  
John B. Buse
Keyword(s):  
Claims Data ◽  
Cardiovascular Effects ◽  
Dipeptidyl Peptidase ◽  
Dipeptidyl Peptidase 4 ◽  
Medicare Claims ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Medicare Claims Data

Cardiovascular effects of dipeptidyl peptidase-4 inhibitors in diabetic patients: A meta-analysis

2015 ◽  
Vol 181 ◽  
pp. 239-244 ◽  
Author(s):  
Gianluigi Savarese ◽  
Pasquale Perrone-Filardi ◽  
Carmen D'Amore ◽  
Cristiana Vitale ◽  
Bruno Trimarco ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Cardiovascular Effects ◽  
Dipeptidyl Peptidase ◽  
Diabetic Patients ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors

scholarly journals THEEFFECT OF DIPEPTIDYL PEPTIDASE-4 INHIBITORS ON CARDIOVASCULAR DISEASE RISK IN TYPE 2 DIABETES MELLITUS

2016 ◽  
Vol 9 (1) ◽  
pp. 254
Author(s):  
Marwa K.a. Tolba ◽  
Khaled A. El Khashab ◽  
Amira S.a. Said
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiovascular Effects ◽  
Dipeptidyl Peptidase ◽  
Ventricular Performance ◽  
Dipeptidyl Peptidase 4 ◽  
Coronary Syndrome ◽  
Dipeptidyl Peptidase 4 Inhibitors

<p><strong>Objective: </strong>The aim of this study was is to investigate the proposed beneficial cardiovascular effects of a novel class of antidiabetic drugs named; dipeptidyl peptidase 4 inhibitors. In this study, we compared the effect of using add-on therapy of vildagliptin (dipeptidyl peptidase-4 inhibitor; DPP-4i) and gliclazide (sulphonylurea; SU) to that when using gliclazide monotherapy in patients with type 2 diabetes mellitus (T2DM) and acute coronary syndrome (ACS) on different cardiovascular outcomes.<strong></strong></p><p><strong>Methods: </strong>A total of 60 patients diagnosed with T2DM, and ACS were randomly recruited into two treatment groups each of 30 patients to receive either gliclazide monotherapy (SU) or vildagliptin (DPP4i)+gliclazide (SU) add-on therapy, administered in a double-blind fashion. Outpatient visits were scheduled at 3, 6, and 12 mo where patient was reevaluated for cardiovascular (CV) outcomes and followed up for any arising cardiovascular complication.<strong></strong></p><p><strong>Results: </strong>The vildagliptin (DPP4i) plus gliclazide (SU) add-on therapy group have significantly shown more improved glycemic control, lipid profile and ventricular performance compared to gliclazide (SU) monotherapy group with p values&lt;0.05.<strong></strong></p><p dir="LTR"><strong>Conclusion: </strong>Vildagliptin as a DPP4i provides favourable cardiovascular effects beyond glucose control. Yet, its long-term safety and efficacy data still needs further investigations.</p>

scholarly journals The Nonglycemic Actions of Dipeptidyl Peptidase-4 Inhibitors

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Na-Hyung Kim ◽  
Taeyang Yu ◽  
Dae Ho Lee
Keyword(s):  
Randomized Clinical Trials ◽  
Cardiovascular Effects ◽  
Dipeptidyl Peptidase ◽  
Protective Effects ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors ◽  
Glucagon Like Peptide 1 ◽  
Stimulation Of

A cell surface serine protease, dipeptidyl peptidase 4 (DPP-4), cleaves dipeptide from peptides containing proline or alanine in the N-terminal penultimate position. Two important incretin hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), enhance meal-stimulated insulin secretion from pancreaticβ-cells, but are inactivated by DPP-4. Diabetes and hyperglycemia increase the DPP-4 protein level and enzymatic activity in blood and tissues. In addition, multiple other functions of DPP-4 suggest that DPP-4 inhibitor, a new class of antidiabetic agents, may have pleiotropic effects. Studies have shown that DPP-4 itself is involved in the inflammatory signaling pathway, the stimulation of vascular smooth cell proliferation, and the stimulation of oxidative stress in various cells. DPP-4 inhibitor ameliorates these pathophysiologic processes and has been shown to have cardiovascular protective effects in bothin vitroandin vivoexperiments. However, in recent randomized clinical trials, DPP-4 inhibitor therapy in high risk patients with type 2 diabetes did not show cardiovascular protective effects. Some concerns on the actions of DPP-4 inhibitor include sympathetic activation and neuropeptide Y-mediated vascular responses. Further studies are required to fully characterize the cardiovascular effects of DPP-4 inhibitor.

scholarly journals Effects of Dipeptidyl Peptidase-4 Inhibitors and Sulfonylureas on Cognitive and Physical Function in Nursing Home Residents

2021 ◽  
Author(s):  
Andrew R. Zullo ◽  
Matthew S. Duprey ◽  
Robert J. Smith ◽  
Roee Gutman ◽  
Sarah D. Berry ◽  
...  
Keyword(s):  
Nursing Home ◽  
Cognitive Decline ◽  
Mental Status ◽  
Physical Functioning ◽  
Functional Decline ◽  
Altered Mental Status ◽  
Dipeptidyl Peptidase ◽  
Dipeptidyl Peptidase 4 ◽  
Medicare Claims ◽  
Dipeptidyl Peptidase 4 Inhibitors

Aims: Dipeptidyl peptidase-4 inhibitors (DPP4Is) may mitigate hypoglycemia-mediated declines in cognitive and physical functioning compared to sulfonylureas (SUs), yet comparative studies are unavailable among older adults, especially nursing home (NH) residents. We evaluated the effects of DPP4Is versus SUs on cognitive and physical functioning among NH residents. Materials and Methods: This new-user cohort study included long-stay NH residents aged ≥65 years from the 2007-2010 national US Minimum Data Set (MDS) clinical assessments and linked Medicare claims. We measured cognitive decline from the validated 6-point MDS Cognitive Performance Scale, functional decline from the validated 28-point MDS Activities of Daily Living scale, and hospitalizations or emergency department visits for altered mental status from Medicare claims. We compared 180-day outcomes in residents who initiated a DPP4I versus SU after propensity score matching using Cox regression models. Results: The cohort (N=1,784) had a mean (SD) age of 80 (8) years and was 73% female. Approximately 46% had no or mild cognitive impairment and 35% had no or mild functional impairment before treatment initiation. Compared to SU users, DPP4I users had statistically similar 180-day rates of cognitive decline (HR=0.61, 95%CI 0.31-1.19), altered mental status events (HR=0.71, 95%CI 0.39-1.27), and functional decline (HR=0.89, 95%CI 0.51-1.56). Conclusions: Rates of cognitive and functional decline were not markedly reduced among DPP4I users compared to SU users, but the point estimates and lower 95% confidence bounds do not rule out the possibility that DPP4Is result in reduced rates. Larger studies with greater statistical power should resolve this remaining uncertainty.

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