TY - JOUR
T1 - Cardiovascular events and all-cause mortality in patients with type 2 diabetes treated with dipeptidyl peptidase-4 inhibitors: An extensive meta-analysis of randomized controlled trials
AU - Mannucci, Edoardo
AU - Nreu, Besmir
AU - Montereggi, Chiara
AU - Ragghianti, Benedetta
AU - Gallo, Marco
AU - Giaccari, Andrea
AU - Monami, Matteo
AU - Candido, Riccardo
AU - Pintaudi, Basilio
AU - Targher, Giovanni
AU - Monache, Lina D.
AU - Masini, Maria L.
AU - Mazzone, Fulvia
AU - Medea, Gerardo
AU - Trento, Marina
AU - Turchetti, Giuseppe
PY - 2021
Y1 - 2021
N2 - Aims: Meta-analyses of randomized trials on Dipeptidyl Peptidase-4 inhibitors (DPP4i) reported discordant results on major cardiovascular events (MACE), mortality, and heart failure. Aim of this meta-analysis of randomized trials is the assessment of the cardiovascular safety of DPP4i. Data synthesis: A Medline, Embase, Cochrane database search for sitagliptin, vildagliptin, omarigliptin, saxagliptin, alogliptin, trelagliptin, anagliptin, linagliptin, gemigliptin, evogliptin, and teneligliptin was performed up to up January 1st, 2020. All trials with a duration ≥24 weeks and comparing the effects of DPP4i with placebo or active drugs were collected. Mantel–Haenszel odds ratio (MH-OR) with 95% Confidence Interval (95% CI) was calculated for all outcomes defined above. A total of 182 eligible trials were identified. DPP-4i were not associated with an increased risk of MACE (MH-OR 0.99 [0.93, 1.04]), all-cause mortality (MH-OR 0.99 [0.93, 1.06]), and heart failure (MH-OR 1.05 [0.96, 1.15]) with no significant differences across individual molecules, except for saxagliptin, which was associated with an increased risk of heart failure. Conclusions: As a class, DPP4i are not associated with any increase or reduction of MACE, all-cause mortality, and heart failure. Saxagliptin seems to be associated with an increased risk of hospitalization for heart failure.
AB - Aims: Meta-analyses of randomized trials on Dipeptidyl Peptidase-4 inhibitors (DPP4i) reported discordant results on major cardiovascular events (MACE), mortality, and heart failure. Aim of this meta-analysis of randomized trials is the assessment of the cardiovascular safety of DPP4i. Data synthesis: A Medline, Embase, Cochrane database search for sitagliptin, vildagliptin, omarigliptin, saxagliptin, alogliptin, trelagliptin, anagliptin, linagliptin, gemigliptin, evogliptin, and teneligliptin was performed up to up January 1st, 2020. All trials with a duration ≥24 weeks and comparing the effects of DPP4i with placebo or active drugs were collected. Mantel–Haenszel odds ratio (MH-OR) with 95% Confidence Interval (95% CI) was calculated for all outcomes defined above. A total of 182 eligible trials were identified. DPP-4i were not associated with an increased risk of MACE (MH-OR 0.99 [0.93, 1.04]), all-cause mortality (MH-OR 0.99 [0.93, 1.06]), and heart failure (MH-OR 1.05 [0.96, 1.15]) with no significant differences across individual molecules, except for saxagliptin, which was associated with an increased risk of heart failure. Conclusions: As a class, DPP4i are not associated with any increase or reduction of MACE, all-cause mortality, and heart failure. Saxagliptin seems to be associated with an increased risk of hospitalization for heart failure.
KW - DPP-4 inhibitors
KW - Major cardiovascular adverse events
KW - Meta-analysis
KW - DPP-4 inhibitors
KW - Major cardiovascular adverse events
KW - Meta-analysis
UR - http://hdl.handle.net/10807/184279
U2 - 10.1016/j.numecd.2021.06.002
DO - 10.1016/j.numecd.2021.06.002
M3 - Article
SN - 0939-4753
VL - 31
SP - 2745
EP - 2755
JO - NMCD. NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
JF - NMCD. NUTRITION METABOLISM AND CARDIOVASCULAR DISEASES
ER -
