Cardiovascular Effects of Incretin-Based Therapies

Annual Review of Medicine
William B White, William L Baker

Abstract

The incretin-based therapies, dipeptidyl peptidase-4 (DPP4) inhibitors and glucagon-like peptide-1 (GLP-1) analogs, are important new classes of therapy for type 2 diabetes mellitus (T2DM). These agents prolong the action of the incretin hormones, GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), by inhibiting their breakdown. The incretin hormones improve glycemic control in T2DM by increasing insulin secretion and suppressing glucagon levels. The cardiovascular (CV) effects of the incretin-based therapies have been of substantial interest since 2008, when the US Food and Drug Administration began to require that all new therapies for diabetes undergo rigorous assessment of CV safety through large-scale CV outcome trials. This article reviews the most recent CV outcome trials of the DPP-4 inhibitors (SAVOR-TIMI 53, EXAMINE, and TECOS) as evidence that the incretin-based therapies have acceptable CV safety profiles for patients with T2DM. The studies differ with regard to patient population, trial duration, and heart failure outcomes but show similar findings for CV death, nonfatal myocardial infarction, and stroke, as well as hospitalization for unstable angina.

References

Sep 9, 2004·American Journal of Physiology. Endocrinology and Metabolism·Thomas NyströmAke Sjöholm
Jul 19, 2005·American Journal of Physiology. Heart and Circulatory Physiology·Lazaros A NikolaidisRichard P Shannon
Oct 22, 2005·JAMA : the Journal of the American Medical Association·Steven E NissenEric J Topol
Feb 21, 2006·The Journal of Pharmacology and Experimental Therapeutics·Tingcun ZhaoRichard P Shannon
Mar 14, 2007·Endocrine Reviews·Bernardo L Wajchenberg
May 15, 2007·Gastroenterology·Laurie L Baggio, Daniel J Drucker
May 23, 2007·The New England Journal of Medicine·Steven E Nissen, Kathy Wolski
Jul 12, 2007·JAMA : the Journal of the American Medical Association·Renee E AmoriAnastassios G Pittas
Jun 10, 2008·The New England Journal of Medicine·Anushka PatelFlorence Travert
Sep 12, 2008·The New England Journal of Medicine·Allison B Goldfine
Jan 20, 2009·Biochemical and Biophysical Research Communications·Kunio HirataTakashi Uzu
Feb 7, 2009·Journal of the American College of Cardiology·Leo TimmersImo E Hoefer
Feb 17, 2009·Bioorganic & Medicinal Chemistry·Shrikanth H Havale, Manojit Pal
Jan 19, 2010·American Journal of Physiology. Heart and Circulatory Physiology·Mads HalbirkHenrik Wiggers
Oct 1, 2010·Current Diabetes Reviews·Somsuvra B GhatakShital J Panchal
Nov 20, 2010·Cardiovascular Drugs and Therapy·Barbara HuisamenAmanda Lochner
Mar 4, 2011·The New England Journal of Medicine·Hertzel C GersteinWilliam T Friedewald
Mar 15, 2011·Vascular Pharmacology·Zubair ShahSanjay Rajagopalan
Sep 17, 2011·European Heart Journal·Jacob LønborgThomas Engstrøm
Nov 3, 2011·European Journal of Heart Failure·Nelson GomezKathleen Mc Entee
Feb 11, 2012·Endocrine Reviews·John R Ussher, Daniel J Drucker
Apr 13, 2012·Circulation. Cardiovascular Interventions·Jacob LønborgThomas Engstrøm
Jun 13, 2012·Clinical Pharmacokinetics·Larry K GolightlyMichael T McDermott
Sep 5, 2012·Nature Reviews. Endocrinology·Juris J Meier
Nov 7, 2012·Annals of Internal Medicine·Steven E Nissen
Mar 19, 2013·American Journal of Physiology. Heart and Circulatory Physiology·Ayako TakahashiMasafumi Kitakaze

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Citations

Feb 27, 2016·Journal of Molecular and Cellular Cardiology·Gabriel A GriloLisandra E de Castro Brás
Jun 28, 2016·Cell Metabolism·Daniel J Drucker
Sep 23, 2016·Expert Opinion on Drug Safety·Puneet Gupta, William B White
Aug 10, 2018·Diabetes, Obesity & Metabolism·Clifford J Bailey, Nikolaus Marx
Aug 16, 2018·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Kuan-Yin KoYen-Wen Wu
Jan 28, 2021·Diabetes, Obesity & Metabolism·So-Hee ParkJu-Young Shin
Jan 15, 2021·International Journal of Molecular Sciences·María Aguilar-BallesterHerminia González-Navarro

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