Sitagliptin, a dipeptidyl peptidase 4 inhibitor, has demonstrated favourable results in a clinical trial of patients with type 2 diabetes and cardiovascular disease
Sitagliptin is a dipeptidyl peptidase 4 inhibitor that acts to increase two proteins: glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic peptide (GIP). These two proteins are usually produced after eating, and help to maintain blood sugar levels.
A report of sitagliptin in the treatment of patients with type 2 diabetes and cardiovascular disease was published this month in the New England Journal of Medicine. This large randomized trial was designed to assess the long term cardiovascular effects of sitagliptin in this patient population.
Over 14 500 patients were recruited to take part in the study, conducted in 38 countries. The study reported no change in incidence of death from any cause, from cardiovascular-related death, or from non-cardiovascular-related death. The rate of hospitalization for heart failure was not increased in the sitagliptin group compared with the control group.
In terms of glycemic control, there was not a significant increase in the rate of severe hypoglycemia in the sitagliptin group when compared to the control group. In addition, patients taking sitagliptin were less likely to use any additional anti-hyperglycemic medication, or long-term insulin therapy while taking sitagliptin.
The authors report that the results of the sitagliptin trial were similar to other DPP-4 inhibitors that have been tested, including; saxagliptin and alogliptin, which also did not increase the rate of cardiovascular events.
Overall, the study of sitagliptin in patients with type 2 diabetes and cardiovascular disease seemed favourable, with no apparent increase in the occurrence of major adverse cardiovascular events, or hospitalization for heart failure reported.
Green, JB, Bethel, MA, Armstrong, PW, Buse, JB, Engel, SS, Garg, J, Josse, R, Kaufman, KD, Koglin, J, Korn, S, Lachin, JM, McGuire, DK, Pencina, MJ, Standl, E, Stein, PP, Suryawanshi, S, Van de Werf, F, Peterson, ED, Holman, RR, for the TECOS Study Group “Effect of Sitagliptin on Cardiovascular Outcomes in Type 2 Diabetes” New England Journal of Medicine 2015; 373:232-242 July 16, 2015 DOI: 10.1056/NEJMoa1501352
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Written by Deborah Tallarigo, PhD