Effect of linagliptin, a dipeptidyl peptidase-4 inhibitor, compared with the sulfonylurea glimepiride on cardiovascular outcomes in Asians with type 2 ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-06-27

AUTHORS

Takashi Kadowaki, Guang Wang, Julio Rosenstock, Daisuke Yabe, Yongde Peng, Keizo Kanasaki, Yiming Mu, Michaela Mattheus, Annett Keller, Tomoo Okamura, Odd Erik Johansen, Nikolaus Marx

ABSTRACT

ObjectiveLinagliptin, a dipeptidyl peptidase-4 inhibitor, recently demonstrated cardiovascular (CV) safety versus placebo in Asians with advanced type 2 diabetes mellitus (T2DM) in the CARMELINA® trial. We assessed its CV safety compared with the sulfonylurea glimepiride in Asians with relatively early T2DM in the CAROLINA® trial.MethodsBased on prespecified and post hoc subgroup analyses of the multinational CAROLINA® trial in which adults with relatively early T2DM and elevated CV risk were randomized to linagliptin or glimepiride added to usual care, we analyzed data for participants from Asian countries. This included the primary outcome defined as time to first CV death, non-fatal myocardial infarction, or non-fatal stroke [three-point major adverse cardiovascular events (3P-MACE)].ResultsOf the 6033 participants, 933 (15.5%) were from Asia. During a median follow-up of 6.2 years, 3P-MACE occurred in 9.5% and 11.1% of the linagliptin and glimepiride groups, respectively (hazard ratio [HR] 0.85; 95% confidence interval [CI] 0.57–1.26]), consistent with the overall population (HR 0.98; 95% CI 0.84–1.13; P = 0.17 for treatment by region interaction). Similarly, there were no significant differences between groups for other outcomes, including CV death (HR 0.73; 95% CI 0.38–1.38), non-CV mortality (HR 0.76; 95% CI 0.37–1.57) and hospitalization for heart failure (HR 0.89; 95% CI 0.36–2.19). Hypoglycemia adverse events occurred in 13.1% of linagliptin patients versus 42.1% of glimepiride patients (HR 0.25; 95% CI 0.19–0.33; P < 0.0001) despite similar glycemic control. Body weight was slightly lower with linagliptin relative to glimepiride: weighted average mean difference over 256 weeks of − 1.82 kg (95% CI − 2.28 to − 1.35).ConclusionsIn Asian patients, linagliptin demonstrated similar CV safety to glimepiride with a markedly lower rate of hypoglycemia and modestly lower weight. More... »

PAGES

87-100

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s13340-020-00447-5

DOI

http://dx.doi.org/10.1007/s13340-020-00447-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1128815350

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33479584


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