Incretin-Based Drugs and Mortality in Patients with Type 2 Diabetes

In a recent trial, patients with type 2 diabetes and cardiovascular (CV) disease or risk factors randomized to the dipeptidyl peptidase-4 (DPP-4) inhibitor saxagliptin had a nonstatistically significant increased risk for all-cause mortality compared with patients randomized to placebo (4.9% vs. 4.2%, P=0.15; NEJM JW Gen Med Oct 1 2013 and N Engl J Med 2013; 369:1317). This finding motivated researchers to perform a meta-analysis of the effects of incretin-based treatment with DPP-4 inhibitors (“gliptins”; e.g., saxagliptin, sitagliptin; taken orally) and glucagon-like peptide-1 (GLP-1)−receptor agonists (e.g., exenatide, liraglutide; taken by injection) on risk for all-cause death in more than 155,000 type 2 diabetics. Analysis included 18…