title: Association Between Hospitalization for Heart Failure and Dipeptidyl Peptidase 4 Inhibitors in Patients With Type 2 Diabetes: An Observational Study.
abstract: To examine, among patients with type 2 diabetes, the association between hospitalization for heart failure (hHF) and treatment with dipeptidyl peptidase 4 inhibitors (DPP-4is) versus sulfonylureas (SUs), and treatment with saxagliptin versus sitagliptin.
  
  
  
  This was a retrospective, observational study using a U.S. insurance claims database. Patients initiated treatment between 1 August 2010 and 30 August 2013, and had no use of the comparator treatments in the prior 12 months (baseline). Each comparison consisted of patients matched 1:1 on a propensity score. Time to each outcome was compared between matched groups using Cox models. Analyses were stratified by the presence of baseline cardiovascular disease (CVD). Secondary analyses examined associations between comparator treatments and other selected cardiovascular events.
  
  
  
  After matching, the study included 218,556 patients in comparisons of DPP-4i and SU, and 112,888 in comparisons of saxagliptin and sitagliptin. The hazard ratios (HRs) of hHF were as follows: DPP-4i versus SU (reference): HR 0.95 (95% CI 0.78-1.15), P = 0.580 for patients with baseline CVD; HR 0.59 (95% CI 0.38-0.89), P = 0.013 for patients without baseline CVD; saxagliptin versus sitagliptin (reference): HR 0.95 (95% CI 0.70-1.28), P = 0.712 for patients with baseline CVD; HR 0.99 (95% CI 0.56-1.75), P = 0.972 for patients without baseline CVD. Comparisons of the individual secondary and composite cardiovascular outcomes followed a similar pattern.
  
  
  
  In patients with type 2 diabetes, there was no association between hHF, or other selected cardiovascular outcomes, and treatment with a DPP-4i relative to SU or treatment with saxagliptin relative to sitagliptin.
authors.affiliation: Georgetown University Medical Center, Washington, DC.
authors.forename: Alex Z
authors.initials: AZ
authors.lastname: Fu
authors.affiliation: Truven Health Analytics, Bethesda, MD stephen.johnston@truvenhealth.com.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Johnston
authors.affiliation: AstraZeneca Pharmaceuticals, LP, Fort Washington, PA.
authors.forename: Ameen
authors.initials: A
authors.lastname: Ghannam
authors.affiliation: MedImmune, LLC, Gaithersburg, MD.
authors.forename: Katherine
authors.initials: K
authors.lastname: Tsai
authors.affiliation: Truven Health Analytics, Bethesda, MD.
authors.forename: Katherine
authors.initials: K
authors.lastname: Cappell
authors.affiliation: Truven Health Analytics, Bethesda, MD.
authors.forename: Robert
authors.initials: R
authors.lastname: Fowler
authors.affiliation: Truven Health Analytics, Bethesda, MD.
authors.forename: Ellen
authors.initials: E
authors.lastname: Riehle
authors.affiliation: Truven Health Analytics, Bethesda, MD.
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Cole
authors.affiliation: AstraZeneca Pharmaceuticals, LP, Fort Washington, PA.
authors.forename: Iftekhar
authors.initials: I
authors.lastname: Kalsekar
authors.affiliation: AstraZeneca Pharmaceuticals, LP, Fort Washington, PA.
authors.forename: John
authors.initials: J
authors.lastname: Sheehan
mesh_terms: D000218:Adamantane / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004151:Dipeptides / Q000627:therapeutic use; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy*; D006760:Hospitalization; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D000068900:Sitagliptin Phosphate / Q000627:therapeutic use; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D004151:Dipeptides; D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; C502994:saxagliptin; D000218:Adamantane; D000068900:Sitagliptin Phosphate