In the Journals

No increased heart failure risk with incretin therapies in type 2 diabetes

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March 24, 2016

Treatment with incretin-based therapies is not associated with increased risk for heart failure in patients with type 2 diabetes vs. patients taking combination oral antidiabetic therapies, according to a recent analysis.

“Our large, population-based study was specifically designed to assess the association between incretin-based drugs and heart failure in the real-world setting of clinical practice,” Kristian Filion, PhD, FAHA, assistant professor of medicine at McGill University and principal investigator at Lady Davis Institute, Jewish General Hospital in Quebec, Canada, and colleagues wrote. “The pooled estimates and almost all site-specific estimates suggested either null or protective effects.”

Kristian Filion

Kristian Filion

In a nested, case-control analysis, researchers analyzed data from four Canadian provinces, the United States and the United Kingdom, matching each patient hospitalized for heart failure with up to 20 controls from the same cohort based on sex, age, cohort-entry date, duration of diabetes and follow-up time (n = 1,499,650; 29,741 hospitalized for heart failure). Researchers calculated cohort-specific HRs for hospitalization due to heart failure among patients receiving incretin-based drugs vs. patients receiving oral antidiabetic therapies.

Within the cohort, the incidence rate was 9.2 events/1,000 persons per year. Researchers found that rate of hospitalization for heart failure did not increase with the use of incretin-based therapies vs. oral antidiabetic combinations among patients with a history of heart failure (HR = 0.86; 95% CI, 0.62-1.19) or among patients with no heart failure history (HR = 0.82; 95% CI, 0.67-1). Results were similar for DPP-IV inhibitors (HR = 0.84; 95% CI, 0.69-1.02) and glucagon-like peptide-1 receptor agonists (HR = 0.95; 95% CI, 0.83-1.1).

“It would be helpful to do additional analyses by individual incretin-based drug (ie, by molecule), which could explain some of the heterogeneity observed in some of the clinical trials in this area,” Filion told Endocrine Today. “In addition, many of the patients included in our study had a relatively short history of diabetes. In secondary analyses, we checked if the association differed by duration of treated diabetes and, although we found that it did not, it would be helpful to revisit this question in a few years as additional information becomes available.” – by Regina Schaffer

For more information:

Kristian B. Filion, PhD, FAHA, can be reached at Jewish General Hospital/McGill University, 3755 Cote Ste Catherine, Suite H416.1, Montreal, Quebec H3T 1E2, Canada; email: Kristian.filion@mcgill.ca.

Disclosure: The researchers report no relevant financial disclosures.

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