Kang-Ling Wang1, Chia-Jen Liu2, Tze-Fan Chao2, Chi-Ming Huang3, Cheng-Hsueh Wu2, Su-Jung Chen2, Chiu-Mei Yeh4, Tzeng-Ji Chen5, Shing-Jong Lin6, Chern-En Chiang7. 1. General Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. 2. Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. 3. School of Medicine, National Yang-Ming University, Taipei, Taiwan. 4. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 5. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan. 6. Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan. Electronic address: sjlin@vghtpe.gov.tw. 7. General Clinical Research Center, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan. Electronic address: cechiang@vghtpe.gov.tw.
Abstract
BACKGROUND: Saxagliptin was associated with an increased risk of hospitalization for heart failure (HHF) in diabetic patients with high cardiovascular risk. This study assessed the risk of HHF during an exposure to sitagliptin in general diabetic patients. METHODS: In Taiwan National Health Insurance research database, a study of the beneficiaries aged ≥ 45 years with diabetes treated with or without sitagliptin between March 2009 and July 2011 was conducted. Patients treated with sitagliptin were matched to patients never exposed to a dipeptidyl peptidase-4 (DPP-4) inhibitor by the propensity score methodology. The outcome measures were the first and the total number of HHF, and mortality for heart failure or all causes. RESULTS: A total of 8288 matched pairs of patients were analyzed. During a median of 1.5 years, the first event of HHF occurred in 339 patients with sitagliptin and 275 patients never exposed to a DPP-4 inhibitor (hazard ratio: 1.21, 95% confidence interval: 1.04-1.42, P = 0.017); all-cause mortality was similar (hazard ratio: 0.87, 95% confidence interval: 0.74-1.03, P = 0.109). The risk for HHF was proportional to exposure (hazard ratio: 1.09, 95% confidence interval: 1.06-1.11, P < 0.001 for every 10% increase in adherence to sitagliptin). Overall, there were 935 events of HHF, in which the association between the number of HHF and the adherence to sitagliptin was linear. The greatest total number of HHF occurred in the patients with the highest adherence. CONCLUSIONS: The use of sitagliptin was associated with a higher risk of HHF but no excessive risk for mortality was observed.
BACKGROUND:Saxagliptin was associated with an increased risk of hospitalization for heart failure (HHF) in diabeticpatients with high cardiovascular risk. This study assessed the risk of HHF during an exposure to sitagliptin in general diabeticpatients. METHODS: In Taiwan National Health Insurance research database, a study of the beneficiaries aged ≥ 45 years with diabetes treated with or without sitagliptin between March 2009 and July 2011 was conducted. Patients treated with sitagliptin were matched to patients never exposed to a dipeptidyl peptidase-4 (DPP-4) inhibitor by the propensity score methodology. The outcome measures were the first and the total number of HHF, and mortality for heart failure or all causes. RESULTS: A total of 8288 matched pairs of patients were analyzed. During a median of 1.5 years, the first event of HHF occurred in 339 patients with sitagliptin and 275 patients never exposed to a DPP-4 inhibitor (hazard ratio: 1.21, 95% confidence interval: 1.04-1.42, P = 0.017); all-cause mortality was similar (hazard ratio: 0.87, 95% confidence interval: 0.74-1.03, P = 0.109). The risk for HHF was proportional to exposure (hazard ratio: 1.09, 95% confidence interval: 1.06-1.11, P < 0.001 for every 10% increase in adherence to sitagliptin). Overall, there were 935 events of HHF, in which the association between the number of HHF and the adherence to sitagliptin was linear. The greatest total number of HHF occurred in the patients with the highest adherence. CONCLUSIONS: The use of sitagliptin was associated with a higher risk of HHF but no excessive risk for mortality was observed.
Authors: Mugdha Gokhale; John B Buse; Michele Jonsson Funk; Jennifer Lund; Virginia Pate; Ross J Simpson; Til Stürmer Journal: Diabetes Obes Metab Date: 2017-03-17 Impact factor: 6.577
Authors: Flory T Muanda; Matthew A Weir; Lavanya Bathini; Kristin K Clemens; Vlado Perkovic; Manish M Sood; Eric McArthur; Jessica M Sontrop; Richard B Kim; Amit X Garg Journal: Clin J Am Soc Nephrol Date: 2020-11-25 Impact factor: 8.237
Authors: Carlo B Giorda; Roberta Picariello; Barbara Tartaglino; Lisa Marafetti; Fabiana Di Noi; Annalisa Alessiato; Giuseppe Costa; Roberto Gnavi Journal: BMJ Open Date: 2015-06-05 Impact factor: 2.692