The cardiovascular safety trials of DPP-4 inhibitors, GLP-1 agonists, and SGLT2 inhibitors.
Trends Cardiovasc Med
; 27(3): 194-202, 2017 04.
Article
em En
| MEDLINE
| ID: mdl-28291655
ABSTRACT
In this paper, we review the results of large, double-blind, placebo-controlled randomized trials mandated by the US Food and Drug Administration to examine the cardiovascular safety of newly-approved antihyperglycemic agents in patients with type 2 diabetes. The cardiovascular effects of dipeptidyl peptidase-4 (DPP-4) inhibitors remain controversial while these drugs did not reduce or increase the risk of primary, pre-specified composite cardiovascular outcomes, one DPP-4 inhibitor (saxagliptin) increased the risk of hospitalization for heart failure in the overall population; another (alogliptin) demonstrated inconsistent effects on heart failure hospitalization across subgroups of patients, and a third (sitagliptin) demonstrated no effect on heart failure. Evidence for cardiovascular benefits of glucagon-like peptide-1 (GLP-1) agonists has been similarly heterogeneous, with liraglutide and semaglutide reducing the risk of composite cardiovascular outcomes, but lixisenatide having no reduction or increase in cardiovascular risk. The effect of GLP-1 agonists on retinopathy remains a potential concern. In the only completed trial to date to assess a sodium-glucose cotransporter-2 (SGLT2) inhibitor, empagliflozin reduced the risk of composite cardiovascular endpoints, predominantly through its impact on cardiovascular mortality and heart failure hospitalization.
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Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Glicemia
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Doenças Cardiovasculares
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Dipeptidil Peptidase 4
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Diabetes Mellitus Tipo 2
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Peptídeo 1 Semelhante ao Glucagon
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Inibidores da Dipeptidil Peptidase IV
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Incretinas
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Inibidores do Transportador 2 de Sódio-Glicose
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article