DPP-4 inhibitors and cardiovascular disease in type 2 diabetes mellitus. Expectations, observations and perspectives
作者： Enzo Bonora , Massimo Cigolini
DOI: 10.1016/J.NUMECD.2016.03.002
关键词:
摘要: Abstract Aims Cardiovascular disease (CVD) is the greatest burden of type 2 diabetes mellitus (T2DM) in terms morbility, mortality and costs for individuals societies. Therefore, its prevention a major goal care. Optimal treatment hyperglycemia certainly instrumental to CVD prevention. means both establishing most appropriate glycemic target given individual selecting medication(s) with favourable benefit/safety ratio. safety, if not clear benefit, required all antidiabetic agents. Dipeptidyl-peptidase-4 (DPP-4) inhibitors are among classes agents recently made available A question be addressed effect these compounds on CVD. Expectations were high their mechanism action, which targets also post-prandial glucose minimize hypoglycemia risk, thereby providing sort global control, some potentially beneficial extra-glycemic effects. This article reviews existing literature this issue. Data synthesis published so far document that DPP-4 have wide spectrum effects reducing risk as well intermediate or surrogate endpoints. These data heralded better outcome. Accordingly, pooling safety from phase 3 4 studies conducted suggested use might translate into three outcome RCTs alogliptin, saxagliptin sitagliptin documented no harm but did show any benefit events. modest significant increased hospitalization heart failure was observed alogliptin (only subjects history before randomization) sitagliptin. study currently progress linagliptin will provide further insights issue benefit. Conclusions It should considered alternative oral generally do possess profile than them, indeed, used caution because adverse vasculature. Overall, selection agent(s) mandatory still challenging
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