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)

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

Background

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

Conclusion

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.

References

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Find this article online at Diabetes Care