(HealthDay News) — There are no significant differences in occurrence of cardiovascular disease (CVD) tied to treatment with glucagon-like peptide-1 (GLP-1) receptor agonists compared with dipeptidyl peptidase-4 (DPP-4) inhibitors, second generation sulfonylureas, or insulin, in combination with metformin, according to a study published in Diabetes, Obesity and Metabolism.

Elisabetta Patorno, MD, DrPH, from Brigham and Women’s Hospital in Boston, and colleagues used data from a large U.S. commercial health plan database linked to laboratory test results to identify 3 pairwise 1:1 propensity score (PS)-matched cohorts of type 2 diabetes patients aged at least 18 years treated with metformin who initiated GLP-1 receptor agonists or a comparator — DPP-4 inhibitors (35 534 patients), second generation sulfonylureas (28 138 patients), or insulin (47 068 patients) — between 2005 and 2013.

The researchers found that over 1 year, CVD events per 1000 person-years were similar among PS-matched initiators of GLP-1 receptor agonists vs DPP-4 inhibitors (hazard ratio [HR]=1.02; 95% CI, 0.84-1.24) and among initiators of GLP-1 receptor agonists vs sulfonylureas (HR=0.86; 95% CI, 0.69-1.08). 

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For GLP-1 receptor agonists vs insulin, results were sensitive to the adjustment for HbA1c, after which the HR was 1.01 (95% CI, 0.73-1.41).

“This large study, performing head-to-head comparisons of GLP-1 receptor agonist vs other antidiabetic agents in real-world patients, provides estimates of relative safety precise enough to rule out large differences in CVD risk and adds further understanding to results from recent clinical trials,” the researchers wrote.

Several authors disclosed financial ties to the pharmaceutical industry.


  1. Patorno E, Everett BM, Goldfine AB, et al. Comparative Cardiovascular Safety of Glucagon-Like Peptide-1 Receptor Agonists versus Other Antidiabetic Drugs in Routine Care: a Cohort Study. Diabetes Obes Metab. 2016. doi:10.1111/dom.12665.