Commentary on cardiovascular safety of DPP4Is: Focus on Alogliptin

Abstract

DPP-4 inhibitors are present in the market for almost more than a decade. In Management of T2DM, DPP-4 inhibitors are established therapy option. The precise guidance for the pre- and post-approval and also CV safety of the newer antidiabetic agents was released by the USFDA in 2008. A neutral effect of Pooled safety analyses, as well as retrospective meta-analyses of clinical trials, have consistently demonstrated that DPP-4 inhibitors are not associated with any increase in cardiovascular adverse events, and have even pointed towards a risk reduction. The combination therapy of Alogliptin with other agents like metformin and pioglitazone have been shown to provide better and superior efficacy as compared to individual monotherapy. The hypoglycemic risk is less with Alogliptin. Alogliptin has been shown to be associated with less risk of hepatotoxicity, weight gain, and acute pancreatitis. Alogliptin does not worsen outcomes in patients with a history of heart failure (HF), neither does it increase rate of new hospitalization for heart failure (HF), as per the data from EXAMINE trial.