New oral hypoglycaemics fail to show cardiovascular benefits

BMJ 2013; 347 doi: (Published 06 September 2013) Cite this as: BMJ 2013;347:f5458
  1. Deborah Cohen
  1. 1BMJ

Two trials involving the new oral hypoglycaemic drugs saxagliptin and alogliptin have found that neither reduces the risk of cardiovascular events in the short term, contradicting the findings of an analysis earlier this year.

Saxagliptin and alogliptin are dipeptidyl peptidase-4 (DPP-4) inhibitors and were approved by regulators because they lowered blood glucose in people with diabetes, but it was unclear what effects they might have on the cardiovascular system.

Since 2008, after concerns over the cardiac safety of rosiglitazone, manufacturers of diabetes drugs have to carry out a long term cardiovascular outcome study after approval. One pooled analysis published earlier this year pointed to the possibility that DPP-4 inhibitors lower cardiovascular risk.1

However, both the new trials, published in the New England Journal of Medicine, and conducted as part of the manufacturers’ regulatory obligations, found that this might not be the case.

In the saxagliptin (SAVOR TIMI-53) trial, sponsored by AstraZeneca and Bristol-Myers Squibb, 16 492 patients with a history of, or at risk for, cardiovascular events were randomly assigned to receive saxagliptin or placebo for an average of two …

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