title: Cardiovascular safety of therapies for type 2 diabetes.
abstract: Dipeptidyl peptidase-4 (DPP4) inhibitors, glucagon-like peptide-1 (GLP-1) analogs and sodium-glucose cotransporter 2 (SGLT2) inhibitors are relatively new therapies for the treatment of type 2 diabetes mellitus. Given the high prevalence of cardiovascular complications in patients with type 2 diabetes and recent concerns questioning CV safety of newer antidiabetic medications, cardiovascular safety of these medications requires evaluation. Areas covered: Cardiovascular effects of these drug classes from preclinical and clinical data as well as non-cardiovascular safety issues are delineated from literature searches covering the last decade and up to June 2016. Major clinical trials assessing the cardiovascular safety of GLP-1 agonists (ELIXA and LEADER), DPP-4 inhibitors (SAVOR-TIMI 53, EXAMINE, and TECOS) and SGLT2 inhibitors (EMPA-REG OUTCOME) are reviewed and interpreted. Expert opinion: Based on review of the present evidence, these 3 classes of antihyperglycemic therapies have acceptably safe CV safety profiles for patients with type 2 diabetes. The latest evidence from LEADER and EMPA-REG OUTCOME trials indicate that liraglutide and empagliflozin have cardiovascular benefits that may prove to be of clinical importance in the management of type 2 DM.
authors.affiliation: a Division of Hypertension and Clinical Pharmacology, Calhoun Cardiology Center , University of Connecticut School of Medicine , Farmington , CT , USA.
authors.forename: Puneet
authors.initials: P
authors.lastname: Gupta
authors.affiliation: a Division of Hypertension and Clinical Pharmacology, Calhoun Cardiology Center , University of Connecticut School of Medicine , Farmington , CT , USA.
authors.forename: William B
authors.initials: WB
authors.lastname: White
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000077203:Sodium-Glucose Transporter 2 Inhibitors
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D000077203:Sodium-Glucose Transporter 2 Inhibitors
keywords: Cardiovascular safety; DPP-4 inhibitors; GLP-1 agonists; SGLT-2 inhibitors; type 2 diabetes mellitus