No Increased Short-term Risk of MI, Stroke With DPP-4i vs Sulfonylureas/Thiazolidinediones

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Medicare beneficiaries did not experience an increased risk of myocardial infarction or stroke with DPP-4i therapy comapred to SU and TZD.
Medicare beneficiaries did not experience an increased risk of myocardial infarction or stroke with DPP-4i therapy comapred to SU and TZD.

HealthDay News — For older US Medicare beneficiaries, dipeptidyl peptidase-4 inhibitors (DPP-4i) treatment is not associated with increased cardiovascular (CV) risk relative to sulfonylureas and thiazolidinediones, according to a study published online in Diabetes, Obesity and Metabolism.

Mugdha Gokhale, PhD, from the University of North Carolina at Chapel Hill, and colleagues identified 2 new-user cohorts of Medicare beneficiaries aged >65 years: DPP-4i vs sulfonylureas (30,130 and 68,382 initiators, respectively) and DPP-4i vs thiazolidinediones (20,596 and 13,526, respectively) during 2007 to 2013.

The researchers found that the hazard ratio [HR] for the composite outcome (myocardial infarction [MI], stroke, and all-cause mortality) was 0.75 (95% CI, 0.72-0.79) in the DPP-4i vs sulfonylureas comparison. For DPP-4i and sulfonylureas, respectively, the 1-year risks for MI were 1.00 (95% CI, 0.89-1.12) and 1.47 (95% CI, 1.38-1.56) per 100 patients; the corresponding numbers for stroke risk were 0.98 (95% CI, 0.87-1.10) and 1.09 (95% CI, 1.01-1.17). For DPP-4i vs thiazolidinediones, the HR for the composite outcome was 0.94 (95 percent CI, 0.86 to 1.02). The 1-year risks for MI and stroke were about 0.90 and 0.80, respectively, per 100 patients for both DPP-4i and thiazolidinediones.

"Though limited by the short treatment duration, our study suggests no increased short-term risk of MI stroke or heart failure with DPP-4i versus sulfonylureas/thiazolidinediones," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Reference

Gokhale M, Buse JB, Funk MJ, et al. No increased risk of cardiovascular events in older adults initiating dipeptidyl peptidase 4 inhibitors versus theraputic alternatives [published online February 14, 2017]. Diabetes Obes Metab. doi: 10.1111/dom.12906

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