Physicians' Academy for Cardiovascular Education

DPP4 inhibitor is safe in older diabetic participants

Assessing the Safety of Sitagliptin in Older Participants in the Trial Evaluating Cardiovascular Outcomes With Sitagliptin (TECOS)

Literature - Bethel AM, Engel SS, Green JB, et al. - Diabetes Care 2017; published online ahead of print


Diabetic patients ≥75 years suffer more often from kidney dysfunction, heart failure (HF), and cardiovascular disease (CVD), making therapeutic decisions more complex [1]. Moreover, clinical data from patients with type 2 diabetes mellitus (T2DM) who are ≥75 years, are scarce [2]. In the TECOS trial, the cardiovascular (CV) safety of the DPP4 inhibitor sitagliptin versus placebo on top of standard care was assessed in T2DM patients with CVD [3].

In this analysis of the TECOS trial, baseline characteristics, clinical outcomes and the safety profile for sitagliptin in participants ≥75 years, are described. First these were compared between older and younger participants, than these were compared within the older cohort between sitagliptin and placebo-treated participants.

Main results


In a large group of participants ≥75 years with well-controlled diabetes, sitagliptin did not increase the risk of serious hypoglycaemia and was neutral with respect to CV outcomes during 3 years of follow-up. These results contribute to better decision making, when it comes to the treatment of older diabetic patients in clinical practice.


Show references

Find this article online at Diabetes Care