HealthDay News – There are no significant differences in occurrence of cardiovascular disease (CVD) tied to treatment with glucagon-like peptide-1 receptor agonists (GLP-1 RA) compared with dipeptidyl peptidase-4 inhibitors (DPP-4i), second generation sulfonylureas, or insulin, in combination with metformin, according to a study published online March 22 in Diabetes, Obesity and Metabolism.

Elisabetta Patorno, MD, DrPH, from Brigham and Women’s Hospital in Boston, and colleagues used data from a large US commercial health plan database linked to laboratory test results to identify 3 pairwise 1:1 propensity score (PS)-matched cohorts of type 2 diabetes patients ≥18 years treated with metformin who initiated GLP-1 RA or a comparator—DPP-4i (35 534 patients), second generation sulfonylureas (28 138 patients), or insulin (47 068 patients)—between 2005 and 2013.

Researchers found that over 1 year, CVD events per 1000 person-years were similar among PS-matched initiators of GLP-1 RA vs DPP-4i (hazard ratio [HR]: 1.02; 95% confidence interval [CI]: 0.84-1.24) and among initiators of GLP-1 RA vs sulfonylureas (HR: 0.86; 95% CI: 0.69-1.08). For GLP-1 RA vs insulin, results were sensitive to the adjustment for hemoglobin A1c, after which the HR was 1.01 (95% CI: 0.73-1.41).


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“This large study, performing head-to-head comparisons of GLP-1 RA vs other antidiabetic agents in real-world patients, provides estimates of relative safety precise enough to rule out large differences in CVD risk and adds further understanding to results from recent clinical trials,” the authors wrote.

Disclosures: Several authors disclosed financial ties to the pharmaceutical industry.

Reference

Patorno E, Everett BM, Goldfine AB, et al. Comparative cardiovascular safety of glucagon-like peptide-1 receptor agonists vs other antidiabetic drugs in routine care: a cohort study. Diabetes Obes Metab. 2016. doi: 10.1111/dom.12665.