Diabetes, obesity & metabolism

Starting DPP-4 inhibitor treatment in older adults does not increase heart risk compared to other medicines

Updated

Abstract

Among 30,130 DPP-4 inhibitor initiators, the hazard ratio for the composite cardiovascular outcome compared to sulphonylureas was 0.75 (95% CI 0.72-0.79) over a median treatment duration of 1 year.

  • The 1-year risk of myocardial infarction for DPP-4 inhibitors was 1.00 per 100 patients, while for sulphonylureas it was 1.47.
  • Stroke risks were 0.98 per 100 patients for DPP-4 inhibitors and 1.09 for sulphonylureas.
  • In the comparison of DPP-4 inhibitors with thiazolidinediones, the hazard ratio for the composite outcome was 0.94 (95% CI 0.86-1.02).
  • The 1-year risk for myocardial infarction was approximately 0.90 per 100 patients for both DPP-4 inhibitor and thiazolidinedione initiators.
  • Stroke risk was approximately 0.80 per 100 patients for both groups.

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Full Text

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Funding

Competing interests

Conflict of interest/disclosures: M.G. was a doctoral student at University of North Carolina during the conduct of this study. She is now a full time employee of GlaxoSmithKline. Dr. Buse reports grants, non-financial support and other from Eli Lilly, grants, non-financial support and other from Bristol-Myers Squibb, grants, non-financial support and other from GI Dynamics, non-financial support and other from Elcylex, grants, non-financial support and other from Merck, non-financial support and other from Metavention, non-financial support and other from vTv Pharma, grants, personal fees, non-financial support and other from PhaseBio, grants, non-financial support and other from AstraZeneca, non-financial support and other from Dance Biopharm, non-financial support and other from Quest, grants from Medtronic Minimed, grants, non-financial support and other from Sanofi, grants from Tolerex, grants from Osiris, grants from Halozyme, grants from Johnson & Johnson, grants from Andromeda, grants from Boehringer-Ingelheim, grants from GlaxoSmithKline, grants from Astellas, grants from MacroGenics, grants from Intarcia Therapeutics, grants, non-financial support and other from Lexicon, grants from Scion NeuroStim, grants, non-financial support and other from Novo Nordisk, grants, non-financial support and other from Orexigen, grants, non-financial support and other from Takeda, non-financial support and other from Adocia, outside the submitted work; and I am or have been a member of a variety of non-profit boards: American Diabetes Association, DiabetesSisters, Taking Control of Your Diabetes, AstraZeneca Healthcare Foundation, Bristol-Myers Squib Together on Diabetes Foundation, the National Diabetes Education Program. T.S. receives investigator-initiated research funding and support as Principal Investigator (R01 AG023178) from the National Institute on Aging (NIA), and as Co-Investigator (R01 CA174453; R01 HL118255, R21-HD080214), National Institutes of Health (NIH). He also receives salary support as Director of the Comparative Effectiveness Research (CER) Strategic Initiative, NC TraCS Institute, UNC Clinical and Translational Science Award (UL1TR001111) and as Director of the Center for Pharmacoepidemiology (current members: GlaxoSmithKline, UCB BioSciences, Merck) and research support from pharmaceutical companies (Amgen, AstraZeneca) to the Department of Epidemiology, University of North Carolina at Chapel Hill. Dr. Stürmer does not accept personal compensation of any kind from any pharmaceutical company. He owns stock in Novartis, Roche, BASF, AstraZeneca, Johnsen & Johnsen, and Novo Nordisk. Dr. Lund receives research support from the UNC Oncology Clinical Translational Research Training Program (K12 CA120780), as well as through a Research Starter Award from the PhRMA Foundation to the UNC Department of Epidemiology. M.J.F. receives investigator-initiated research funding and support as Principal Investigator from the National Institutes of Health (NIH), National Heart Lung and Blood Institute (NHLBI, R01 HL118255); as a Co-Investigator from the NIH National Institute on Aging (NIA, R01 AG023178), the NIH National Center for Advancing Translational Sciences (NCATS, 1UL1TR001111), AstraZeneca, and the Patient Centered Outcomes Research Institute (PCORI, 1IP2PI000075). Dr. Jonsson Funk does not accept personal compensation of any kind from any pharmaceutical company, though she receives salary support from the Center for Pharmacoepidemiology in the Department of Epidemiology, Gillings School of Global Public Health (current members: GlaxoSmithKline, UCB BioSciences, Merck).
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