Sitagliptin and other 'gliptins'--why prescribe them?

Expert Opinion on Pharmacotherapy
Sheila A Doggrell, Simon B Dimmitt

Abstract

In 2008, the Federal Drug Administration (FDA) required all new glucose-lowering therapies to show cardiovascular safety, and this applies to the dipeptidyl peptidase (DPP)-4 inhibitors ('gliptins'). At present, there is contradictory evidence on whether the gliptins increase hospitalizations for heart failure. This is an evaluation of the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS) in high risk cardiovascular subjects with type 2 diabetes [1]. TECOS demonstrated non-inferiority for sitagliptin over placebo for the primary outcome, which was cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. There was no difference in the rate of hospitalization for heart failure between sitagliptin and placebo. Despite the results of TECOS, debate over the effects of sitagliptin on the rates of hospitalizations for heart failure continues with some recent studies suggesting increased rates. Recently, empagliflozin (an inhibitor of sodium-glucose cotransporter 2) has been shown to reduce cardiovascular outcomes in subjects with type 2 diabetes, including the rates of hospitalization for heart failure. In our opinion, these positive findings with empagliflozin sugg...Continue Reading

References

Sep 3, 2013·The New England Journal of Medicine·Benjamin M SciricaUNKNOWN SAVOR-TIMI 53 Steering Committee and Investigators
Sep 3, 2013·The New England Journal of Medicine·William B WhiteUNKNOWN EXAMINE Investigators
Apr 2, 2014·Expert Opinion on Drug Safety·Sheila A Doggrell, Simon B Dimmitt
Nov 5, 2014·Hypertension·Edwin K JacksonDelbert G Gillespie
Dec 17, 2014·International Journal of Cardiology·Kang-Ling WangChern-En Chiang
Dec 22, 2014·International Journal of Cardiology·Gianluigi SavareseGiuseppe M C Rosano
Jun 9, 2015·The New England Journal of Medicine·Jennifer B GreenUNKNOWN TECOS Study Group
Sep 16, 2015·American Journal of Physiology. Heart and Circulatory Physiology·Xiao ZhuEdwin K Jackson
Sep 18, 2015·The New England Journal of Medicine·Bernard ZinmanUNKNOWN EMPA-REG OUTCOME Investigators
Sep 21, 2015·International Journal of Cardiology·Ahmed S AbdelmoneimScot H Simpson

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Citations

Jul 28, 2019·Materials·Nayana C F StofellaFábio S Murakami
Sep 22, 2017·Advances in Bioinformatics·Lina RozanoIndu Bala Jaganath

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