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https://read.qxmd.com/read/30767126/cardiovascular-protection-with-anti-hyperglycemic-agents
#1
REVIEW
Prakash Deedwania, Tushar Acharya
Diabetes mellitus is a major risk factor for cardiovascular (CV) disease. Conversely, CV disease is responsible for a majority of the deaths in patients with diabetes. Many drug trials have concentrated on blood glucose (hemoglobin A1c ) reduction. This strategy, while reducing microvascular outcomes like nephropathy and neuropathy, has little or no effect on reducing macrovascular events like heart attack, stroke, and heart failure. It has been postulated that hypoglycemia may counterbalance some of the beneficial effects of anti-hyperglycemic agents, but this is not proven...
February 15, 2019: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://read.qxmd.com/read/30713085/network-meta-analysis-of-nine-large-cardiovascular-outcome-trials-of-new-antidiabetic-drugs
#2
REVIEW
Osamah M Alfayez, Majed S Al Yami, Mohannad Alshibani, Saad B Fallatah, Nasser M Al Khushaym, Razan Alsheikh, Nimer Alkhatib
The aim of this network meta-analysis (NMA) was to indirectly compare the cardiovascular (CV) safety of new antidiabetic medications in patients with type 2 diabetes mellitus (T2DM). DATA SYNTHESIS: A search of the Embase and MEDLINE databases was conducted systematically to identify cardiovascular outcome trials (CVOTs) of new antidiabetic medications (DPP-4 inhibitors, GLP-1 agonists and SGLT-2 inhibitors) in patients with T2DM. The primary outcomes were the composite endpoint of CV death, nonfatal MI, and nonfatal stroke (MACE), death from CV causes, nonfatal MI, nonfatal stroke and death from any cause...
January 31, 2019: Primary Care Diabetes
https://read.qxmd.com/read/30609236/heart-failure-and-type-2-diabetes-from-cvots-with-hope
#3
REVIEW
Dario Giugliano, Juris J Meier, Katherine Esposito
An excess heart failure (HF) risk persists in patients with type 2 diabetes (T2D) despite optimal control of an array of conventional risk factors, including hyperglycaemia. Twelve cardiovascular outcome trials (CVOTs) have been so far published, although none, with the exception of DECLARE with dapagliflozin, has included HF in the primary endpoint. The four trials with dipeptidyl-peptidase inhibitors (DPP-4i) (SAVOR-TIMI 53 with saxagliptin, EXAMINE with alogliptin, TECOS with sitagliptin, and CARMELINA with linagliptin) failed to show any significant effect on HF risk in patients with T2D, with the notable exception of saxagliptin that was associated with a 27% increased risk...
January 4, 2019: Diabetes, Obesity & Metabolism
https://read.qxmd.com/read/30557974/linagliptin-related-pancreatitis-in-a-diabetic-patient-with-biliary-calculus-a-case-report
#4
Nurhayat Ozkan Sevencan, Aysegul Ertinmaz Ozkan, Burcak Kayhan
RATIONALE: Dipeptidyl peptidase-4 inhibitors are commonly used drugs for the treatment of type 2 diabetes mellitus. While acute pancreatitis cases induced by saxagliptin, sitagliptin, and vildagliptin (all of which are members of the dipeptidyl peptidase-4 group) have been reported, there is no clear evidence suggesting that linagliptin may cause pancreatitis, and information in this regard is limited to a few studies. Moreover, no pancreatitis cases have been reported that were directly associated with linagliptin...
December 2018: Medicine (Baltimore)
https://read.qxmd.com/read/30516068/managing-diabetes-and-preventing-heart-disease-have-we-found-a-safe-and-effective-agent
#5
Judy W M Cheng, Vincent J Colucci, James S Kalus, Sarah A Spinler
OBJECTIVE: While improving glycemic control with antihyperglycemics has been demonstrated to reduce microvascular complications, the benefits of reduction in cardiovascular diseases (CVDs) have not been demonstrated with older agents. This article reviews current evidence of the CV outcomes of newer antihyperglycemics approved since 2008. DATA SOURCES: Peer-reviewed articles were identified from MEDLINE (1966 to October 31, 2018) using search terms exenatide, liraglutide, lixisenatide, dulaglutide, semaglutide, alogliptin, linagliptin, saxagliptin, sitagliptin, canagliflozin, dapagliflozin, empagliflozin, mortality, myocardial infarction (MI), heart failure (HF), and stroke...
December 5, 2018: Annals of Pharmacotherapy
https://read.qxmd.com/read/30487758/saxagliptin-but-not-sitagliptin-inhibits-camkii-and-pkc-via-dpp9-inhibition-in-cardiomyocytes
#6
Chintan N Koyani, Christopher Trummer, Niroj Shrestha, Susanne Scheruebel, Benjamin Bourgeois, Ioanna Plastira, Sandra Kickmaier, Harald Sourij, Peter P Rainer, Tobias Madl, Wolfgang Sattler, Brigitte Pelzmann, Ernst Malle, Dirk von Lewinski
Some oral anti-hyperglycemic drugs, including gliptins that inhibit dipeptidyl peptidase 4 (DPP4), have been linked to the increased risk of heart failure (HF) in type-2 diabetic patients. While the cardiovascular safety trial, TECOS, revealed no link between sitagliptin and the risk of HF, a substantial 27% increase in the hospitalization for HF was observed in type-2 diabetic patients treated with saxagliptin within the SAVOR-TIMI 53 trial. A previous in vitro study revealed that saxagliptin impairs the Ca2+ /calmodulin-dependent protein kinase II (CaMKII)-phospholamban (PLB)-sarcoplasmic reticulum Ca2+ -ATPase 2a axis and protein kinase C (PKC) activity in cardiomyocytes leading to impaired cardiac contractility and electrophysiological function...
2018: Frontiers in Physiology
https://read.qxmd.com/read/30318179/mechanism-by-which-dipeptidyl-peptidase-4-inhibitors-increase-the-risk-of-heart-failure-and-possible-differences-in-heart-failure-risk
#7
REVIEW
Motoaki Sano
Dipeptidyl peptidase-4 (DPP-4) inhibitors are oral antidiabetic drugs that safely reduce the blood glucose level over the long term. In Japan, DPP-4 inhibitors have become the oral antidiabetic drugs most frequently prescribed for patients with type 2 diabetes. However, the results of several cardiovascular outcomes studies have suggested that some DPP-4 inhibitors may increase the risk of hospitalization for heart failure. In patients with diabetes, heart failure is the most frequent cardiovascular condition, and it has a negative impact on the quality of life as well as being a potentially fatal complication...
October 11, 2018: Journal of Cardiology
https://read.qxmd.com/read/30273368/influence-of-peer-networks-on-physician-adoption-of-new-drugs
#8
Julie M Donohue, Hasan Guclu, Walid F Gellad, Chung-Chou H Chang, Haiden A Huskamp, Niteesh K Choudhry, Ruoxin Zhang, Wei-Hsuan Lo-Ciganic, Stefanie P Junker, Timothy Anderson, Seth Richards-Shubik
Although physicians learn about new medical technologies from their peers, the magnitude and source of peer influence is unknown. We estimate the effect of peer adoption of three first-in-class medications (dabigatran, sitigliptin, and aliskiren) on physicians' own adoption of those medications. We included 11,958 physicians in Pennsylvania prescribing anticoagulant, antidiabetic, and antihypertensive medications. We constructed 4 types of peer networks based on shared Medicare and Medicaid patients, medical group affiliation, hospital affiliation, and medical school/residency training...
2018: PloS One
https://read.qxmd.com/read/30253968/sitagliptin-for-prevention-of-stress-hyperglycemia-in-patients-without-diabetes-undergoing-general-surgery-a-pilot-randomized-study
#9
Maya Fayfman, Georgia Davis, Elizabeth W Duggan, Maria Urrutia, David Chachkhiani, Joanna Schindler, Francisco J Pasquel, Rodolfo J Galindo, Priyathama Vellanki, David Reyes-Umpierrez, Heqiong Wang, Guillermo E Umpierrez
AIM: We investigated if a dipeptidyl peptidase-4 inhibitor, sitagliptin, can prevent perioperative stress hyperglycemia in patients without prior history of diabetes mellitus undergoing general surgery. METHODS: This double-blind pilot trial randomized general surgery patients to receive sitagliptin (n = 44) or placebo (n = 36) once daily, starting one day prior to surgery and continued during the hospital stay. The primary outcome was occurrence of stress hyperglycemia, defined by blood glucose (BG) >140 mg/dL and >180 mg/dL after surgery...
September 1, 2018: Journal of Diabetes and its Complications
https://read.qxmd.com/read/30145664/effect-of-sitagliptin-on-energy-metabolism-and-brown-adipose-tissue-in-overweight-individuals-with-prediabetes-a-randomised-placebo-controlled-trial
#10
Kimberly J Nahon, Fleur Doornink, Maaike E Straat, Kani Botani, Borja Martinez-Tellez, Gustavo Abreu-Vieira, Jan B van Klinken, Gardi J Voortman, Edith C H Friesema, Jonatan R Ruiz, Floris H P van Velden, Lioe-Fee de Geus-Oei, Frits Smit, Lenka M Pereira Arias-Bouda, Jimmy F P Berbée, Ingrid M Jazet, Mariëtte R Boon, Patrick C N Rensen
AIMS/HYPOTHESIS: The aim of this study was to evaluate the effect of sitagliptin on glucose tolerance, plasma lipids, energy expenditure and metabolism of brown adipose tissue (BAT), white adipose tissue (WAT) and skeletal muscle in overweight individuals with prediabetes (impaired glucose tolerance and/or impaired fasting glucose). METHODS: We performed a randomised, double-blinded, placebo-controlled trial in 30 overweight, Europid men (age 45.9 ± 6.2 years; BMI 28...
November 2018: Diabetologia
https://read.qxmd.com/read/29977422/efficacy-and-patient-satisfaction-of-dipeptidyl-peptidase-4-inhibitor-after-switching-from-once-daily-dpp-4-inhibitor-to-once-weekly-regimen
#11
Katsunori Suzuki, Kazuki Hasegawa, Mio Watanabe
Background: We administered once-weekly dipeptidyl peptidase-4 (DPP-4) inhibitor (W) (used omarigliptin as W in this study) to patients with type 2 diabetes taking once-daily DPP-4 inhibitor (D), and investigated efficacy, safety and patient satisfaction before and after switching to W. Methods: W was administered to 182 patients with type 2 diabetes taking D (used sitagliptin as D in this study), who had been visiting our hospital on an outpatient basis; 164 (90...
August 2018: Journal of Clinical Medicine Research
https://read.qxmd.com/read/29949432/the-efficacy-and-safety-of-co-administration-of-sitagliptin-with-metformin-in-patients-with-type-2-diabetes-at-hospital-discharge
#12
MULTICENTER STUDY
Roma Y Gianchandani, Francisco J Pasquel, Daniel J Rubin, Kathleen M Dungan, Priyathama Vellanki, Heqiong Wang, Isabel Anzola, Patricia Gomez, Israel Hodish, Sangeeta Lathkar-Pradhan, Jennifer Iyengar, Guillermo E Umpierrez
OBJECTIVE: Few randomized controlled trials have focused on the optimal management of patients with type 2 diabetes (T2D) during the transition from the inpatient to outpatient setting. This multicenter open-label study explored a discharge strategy based on admission hemoglobin A1c (HbA1c) to guide therapy in general medicine and surgery patients with T2D. METHODS: Patients with HbA1c ≤7% (53 mmol/mol) were discharged on sitagliptin and metformin; patients with HbA1c between 7 and 9% (53-75 mmol/mol) and those >9% (75 mmol/mol) were discharged on sitagliptinmetformin with glargine U-100 at 50% or 80% of the hospital daily dose...
June 2018: Endocrine Practice
https://read.qxmd.com/read/29949014/cardiovascular-safety-of-empagliflozin-versus-dipeptidyl-peptidase-4-dpp-4-inhibitors-in-type-2-diabetes-systematic-literature-review-and-indirect-comparisons
#13
Chakrapani Balijepalli, Rohan Shirali, Prashanth Kandaswamy, Anastasia Ustyugova, Egon Pfarr, Søren S Lund, Eric Druyts
INTRODUCTION: Clinical trials conducted in patients with type 2 diabetes (T2DM) treated with glucose-lowering drugs and examining cardiovascular-related outcomes have yielded mixed results. In this work, we aimed to assess the relative treatment effects of empagliflozin versus sitagliptin and saxagliptin (dipeptidyl peptidase-4 (DPP-4) inhibitors) on cardiovascular-related outcomes in patients with T2DM. METHODS: We conducted a systematic literature review to identify clinical trials assessing cardiovascular-related outcomes for sitagliptin-, saxagliptin-, and empagliflozin-treated patients with T2DM...
August 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://read.qxmd.com/read/29923323/sex-differences-in-management-and-outcomes-of-patients-with-type-2-diabetes-and-cardiovascular-disease-a-report-from-tecos
#14
Joakim Alfredsson, Jennifer B Green, Susanna R Stevens, Shelby D Reed, Paul W Armstrong, M Angelyn Bethel, Samuel S Engel, Darren K McGuire, Frans Van de Werf, Irene Hramiak, Harvey D White, Eric D Peterson, Rury R Holman
AIM: To examine sex differences in baseline characteristics and outcomes in patients with type 2 diabetes and atherosclerotic vascular disease. MATERIALS AND METHODS: Cox models were used to analyse the association between sex and outcomes in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS), a randomized, placebo-controlled trial assessing the impact of sitagliptin on cardiovascular (CV) outcomes in patients with type 2 diabetes and atherosclerotic vascular disease...
October 2018: Diabetes, Obesity & Metabolism
https://read.qxmd.com/read/29895330/rationale-and-design-of-study-of-dapagliflozin-versus-sitagliptin-treatment-efficacy-on-prevention-of-cardiovascular-risk-factors-in-type-2-diabetes-patients-the-diversity-cvr-study
#15
Fumika Shigiyama, Naoki Kumashiro, Ayako Fuchigami, Takahisa Hirose
BACKGROUND: Recent studies reported that sodium glucose cotransporter 2 (SGLT2) inhibitors reduced the cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus (T2DM) compared to placebo in contrast to no reduction with dipeptidyl peptidase 4 (DPP4) inhibitors. However, there are no comparative studies on the effects of SGLT2 inhibitors and DPP4 inhibitors on HbA1c, body weight and hypoglycemia as risk factors of cardiovascular diseases. The aim of the present ongoing study is to compare the effects of dapagliflozin, a SGLT2 inhibitor, with those of sitagliptin, a DPP4 inhibitor, on cardiovascular risk factors in T2DM patients with inadequate glycemic control...
June 12, 2018: Cardiovascular Diabetology
https://read.qxmd.com/read/29748368/cardiovascular-effects-of-new-oral-glucose-lowering-agents-dpp-4-and-sglt-2-inhibitors
#16
REVIEW
André J Scheen
Cardiovascular disease (CVD) is a major challenge in the management of type 2 diabetes mellitus. Glucose-lowering agents that reduce the risk of major cardiovascular events would be considered a major advance, as recently reported with liraglutide and semaglutide, 2 glucagon-like peptide-1 receptor agonists, and with empagliflozin and canagliflozin, 2 SGLT-2 (sodium-glucose cotransporter type 2) inhibitors, but not with DPP-4 (dipeptidyl peptidase-4) inhibitors. The present review is devoted to CV effects of new oral glucose-lowering agents...
May 11, 2018: Circulation Research
https://read.qxmd.com/read/29573215/longitudinal-medical-resources-and-costs-among-type-2-diabetes-patients-participating-in-the-trial-evaluating-cardiovascular-outcomes-with-sitagliptin-tecos
#17
Shelby D Reed, Yanhong Li, Jose Leal, Larry Radican, Amanda I Adler, Joakim Alfredsson, John B Buse, Jennifer B Green, Keith D Kaufman, Axel Riefflin, Frans Van de Werf, Eric D Peterson, Alastair M Gray, Rury R Holman
AIMS: TECOS, a cardiovascular safety trial (ClinicalTrials.gov identifier: NCT00790205) involving 14 671 patients with type 2 diabetes and cardiovascular disease, demonstrated that sitagliptin was non-inferior to placebo for the primary composite cardiovascular outcome when added to best usual care. This study tested hypotheses that medical resource use and costs differed between these 2 treatment strategies. MATERIALS AND METHODS: Information concerning medical resource use was collected on case report forms throughout the trial and was valued using US costs for: Medicare payments for hospitalizations, medical procedures and outpatient visits, and wholesale acquisition costs (WAC) for diabetes-related medications...
July 2018: Diabetes, Obesity & Metabolism
https://read.qxmd.com/read/29340105/long-term-effects-of-sitagliptin-in-patients-with-type-2-diabetes-mellitus-and-hypertension-results-from-the-prologue-study
#18
Ziliang Ye, Hui Li, Haili Lu, Qiang Su, Lang Li
Background: The effects of sitagliptin in patients with type 2 diabetes mellitus and hypertension are unclear. Therefore, we evaluated the long-term effects of sitagliptin in those patients. Methods: In the PROLOGUE study, 365 patients were diagnosed as type 2 diabetes mellitus and hypertension, and 189 patients in the sitagliptin group, 176 patients in the conventional group. Fasting blood glucose (FBG), HbA1c, systolic pressure (SP), diastolic pressure (DP), serum urea nitrogen (BUN) and serum creatinine (SCR) were measured at the beginning of the study and after 12 and 24 months of treatment...
December 19, 2017: Oncotarget
https://read.qxmd.com/read/29311155/increased-risk-of-severe-hypoglycemic-events-before-and-after-cardiovascular-outcomes-in-tecos-suggests-an-at-risk-type-2-diabetes-frail-patient-phenotype
#19
RANDOMIZED CONTROLLED TRIAL
Eberhard Standl, Susanna R Stevens, Paul W Armstrong, John B Buse, Juliana C N Chan, Jennifer B Green, John M Lachin, Andre Scheen, Florence Travert, Frans Van de Werf, Eric D Peterson, Rury R Holman
OBJECTIVE: Severe hypoglycemic events (SHEs) in type 2 diabetes are associated with subsequent cardiovascular (CV) event risk. We examined whether CV events were associated with subsequent SHE risk. RESEARCH DESIGN AND METHODS: Time-dependent associations between SHEs and a composite CV end point (fatal/nonfatal myocardial infarction or stroke, hospitalization for unstable angina, hospitalization for heart failure [hHF]) were examined post hoc in 14,671 TECOS (Trial Evaluating Cardiovascular Outcomes With Sitagliptin) participants with type 2 diabetes and CV disease followed for a median of 3...
March 2018: Diabetes Care
https://read.qxmd.com/read/29241903/effect-of-dipeptidyl-peptidase-4-inhibitors-on-heart-failure-a-network-meta-analysis
#20
COMPARATIVE STUDY
Wen-Qin Guo, Lang Li, Qiang Su, Wei-Ran Dai, Zi-Liang Ye
BACKGROUND: Previous meta-analyses evaluating the effectiveness of individual dipeptidyl peptidase-4 (DPP-4) inhibitors on the risk of heart failure (HF) were limited because of the small number of trials with direct comparisons between two treatments. METHODS: A Bayesian network meta-analysis was performed to investigate the relationship between DPP-4 inhibitors and the risk of HF in patients with type-2 diabetes mellitus. The primary outcome was the occurrence of HF or hospital admission for HF...
December 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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