July 3rd, 2014
Sitagliptin Associated with Increase in Heart Failure Hospitalizations
The cardiovascular effects of drugs used for glucose control in patients with diabetes have been a subject of controversy for many years now. More recently, attention has started to focus specifically on the risk for heart failure (HF). Now, an observational study will likely raise new questions about the dipeptidyl peptidase (DPP)-4 inhibitor sitagliptin (Januvia, Merck).
In a paper published in JACC Heart Failure, Daniala Weir and colleagues analyzed insurance claims from a database of more than 7600 patients with diabetes and HF. People who took sitagliptin were not more likely than nonusers to have a primary endpoint event (death or all-cause hospitalization). However, they were more likely to be hospitalized for HF (12.5% vs. 9.0%, adjusted OR: 1.84, CI 1.16-2.92).
The authors said their finding “is likely clinically relevant” and might have an impact on the choice of add-on therapy for HF patients with diabetes.
In an accompanying editorial, Deepak Bhatt writes that the findings “add to a small but growing body of evidence that suggests DPP-4 inhibitors as a class of drugs, and possibly diabetes drugs in general, may increase the risk of heart failure.” However, he noted, the “increase in absolute risk, if present at all, appears to be small.”