Cardiovascular Risk With Sitagliptin in Older Patients With Type 2 Diabetes

HealthDay News — Sitagliptin has a neutral effect on cardiovascular risk among older patients with type 2 diabetes, according to a study published in Diabetes Care.

M. Angelyn Bethel, MD, from the Oxford Center for Diabetes in the United Kingdom, and colleagues analyzed baseline characteristics and clinical outcomes for Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS) participants with type 2 diabetes and cardiovascular disease (CVD). Fourteen percent of the 14,351 participants with age recorded were aged at least 75 years.

The researchers found that older participants had significantly higher rates of the primary composite outcome (6.46 vs 3.67 events per 100 person-years; hazard ratio [HR]: 1.72; 95% CI, 1.52-1.94), death (HR: 2.52; 95% CI, 2.20-2.89), severe hypoglycemia (HR: 1.53; 95% CI, 1.15-2.03), and fractures (HR: 1.84; 95% CI, 1.44-2.35) during 2.9 years of median follow-up. 

Sitagliptin did not significantly impact the primary composite outcome in the older cohort (HR: 1.10; 95% CI, 0.89-1.36), nor did it impact death (HR: 1.05; 95% CI, 0.83-1.32), heart failure hospitalization (HR: 0.99; 95% CI, 0.65-1.49), or severe hypoglycemia (HR: 1.03; 95% CI, 0.62-1.71).

“Among older patients with well-controlled type 2 diabetes and cardiovascular disease, sitagliptin had neutral effects on cardiovascular risk and raised no significant safety concerns,” the researchers wrote.

Disclosures: Several authors disclosed financial ties to pharmaceutical companies, including Merck, which manufactures sitagliptin and funded the TECOS trial.

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  1. Bethel MA, Engel SS, Green JB, et al; for the TECOS Study Group. Assessing the Safety of Sitagliptin in Older Participants in the Trial Evaluating Cardiovascular Outcomes With Sitagliptin (TECOS) [published online January 5, 2017]. Diabetes Care. doi:10.2337/dc16-1135