Do “Gliptin” Drugs Raise Risk for Heart Failure?

The FDA requires evidence that new type 2 diabetes therapies do not raise cardiovascular (CV) risk. In previous placebo-controlled trials of dipeptidyl peptidase–4 (DPP-4) inhibitors, saxagliptin (Onglyza) was assessed in 16,500 patients with type 2 diabetes and CV disease or risk factors, and alogliptin (Nesina) was assessed in 5400 diabetic patients with recent episodes of acute coronary syndrome (NEJM JW Gen Med Oct 1 2013 and N Engl J Med 2013; 369:1317 and 1327). In the saxagliptin study, major adverse CV events (i.e., CV death, myocardial infarction, and stroke) occurred with similar frequency during 2 years in the saxagliptin and placebo groups, but incidence of congestive heart failure (CHF) hospitalizations was significantly higher…