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No increased heart failure risk observed with saxagliptin or sitagliptin

A retrospective cohort study found that patients taking saxagliptin or sitagliptin did not have a higher risk for heart failure compared to those taking other commonly-prescribed medications for type 2 diabetes. The findings are published in Annals of Internal Medicine.

Saxagliptin and sitagliptin are a class of oral antihyperglycemic medications called dipeptidyl peptidase-4 (DPP-4) inhibitors. Postmarketing trials have shown an association between DPP-4s and hospitalization for heart failure. However, it is not clear if the increased risk for heart failure seen in the trials is due to properties of the drugs, different patient characteristics between trials, or random error related to multiple hypothesis testing.

In a large cohort study, researchers compared rates of hospitalization for heart failure in new users of DPP-4s to rates in new users of other commonly-prescribed diabetes medications (pioglitazone, second-generation sulfonylureas, long-acting insulin products). The data did not show an increased risk for heart failure hospitalizations among DPP-4 users. The researchers suggest well-designed randomized trials to better understand the association between DPP-4s and heart failure.

Article: Risk for Hospitalized Heart Failure Among New Users of Saxagliptin, Sitagliptin, and Other Antihyperglycemic Drugs: A Retrospective Cohort Study, Sengwee Toh, ScD; Christian Hampp, PhD; Marsha E. Reichman, PhD; David J. Graham, MD, MPH; Suchitra Balakrishnan, MD, PhD; Frank Pucino, PharmD, MPH; Jack Hamilton, AB; Samuel Lendle, PhD; Aarthi Iyer, JD, MPH; Malcolm Rucker, MS; Madelyn Pimentel, BA; Neesha Nathwani, BS; Marie R. Griffin, MD, MPH; Nancy J. Brown, MD; and Bruce H. Fireman, MA, Annals of Internal Medicine, doi:10.7326/M15-2568, published online 26 April 2016.

Editorial: Complementary Efforts Make for Efficient Research, Joseph V. Selby, MD, MPH, Annals of Internal Medicine, doi:10.7326/M16-0869, published online 26 April 2016.