No Excess Risk for Heart Failure Hospitalizations with Dipeptidyl Peptidase–4 Inhibitors

Most postmarketing studies of dipeptidyl peptidase–4 (DPP-4) inhibitors for treating patients with type 2 diabetes have shown no excess cardiovascular risk; however, one randomized trial reported that heart failure–related hospitalizations were more common with saxagliptin (Onglyza) than with placebo (NEJM JW Gen Med Oct 1 2013 and N Engl J Med 2013; 369:1317).

Researchers analyzed an FDA database of claims and clinical information covering 358 million person-years of observation. They compared heart failure–related hospitalizations among new users of saxagliptin or sitagliptin (Januvia) with those among new users of sulfonylureas, pioglitazone, or long-acting insulins. Each pairwise comparison was adjusted for concomitant use of other study…