Gliptin Safety a 'Good Thing'

In New Trials, Saxagliptin and Alogliptin Clear FDA Hurdle on Cardiovascular Safety

Anne L. Peters, MD, CDE


September 13, 2013

This feature requires the newest version of Flash. You can download it here.
In This Article

Hi. I am Dr. Anne Peters from the University of Southern California, and today I am going to talk about the SAVOR[1] and EXAMINE[2] trials. These are big cardiovascular outcome studies examining whether DPP-4 (dipeptidyl peptidase 4) inhibitors are safe in terms of cardiovascular events when compared with placebo.

These 2 very large trials involved participants from around the world. The SAVOR trial included more than 16,000 individuals and looked at saxagliptin vs placebo in patients who either had a history of cardiovascular disease or were at high risk for cardiovascular disease. The EXAMINE trial enrolled more than 5000 patients who were randomly assigned to either alogliptin or placebo. Patients in the EXAMINE trial were sicker than those in SAVOR; they were patients who recently had a myocardial infarction or a hospitalization for unstable angina.

Now let me start with the headline. In terms of the primary outcome, which is cardiovascular death, myocardial infarction, or ischemic stroke, neither DPP-4 inhibitor increased the risk for any of those events; they were neutral and neither increased nor decreased the risk for these cardiovascular events, which is a good thing. It would be nice if they reduced the risk for cardiovascular events, but that was not the case. There is one caveat in terms of congestive heart failure (CHF) risk, which I will talk about in a moment.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.