Montreal—Do type 2 diabetes patients who take incretin-based drugs increase their risk of being hospitalized for heart failure? A very large study of patients in the United States, United Kingdom, and Canada provides reassurance that they do not.

The study, which looked at the likelihood of being hospitalized for heart failure with that therapy compared to commonly used combinations of oral antidiabetic drugs, was published recently in the New England Journal of Medicine.

A past study suggested a link between heart failure and incretin-based drugs including the DPP-4 inhibitors Galvus, Jalra, Januvia, Nesina, Onglyza, Trajenta, and Xiliarx, as well as the GLP-1 analogs Bydureon, Byetta, Saxenda, Trulicity, and Victoza, although the results were not replicated, according to researchers. Background information in the article notes that about 12% of patients with diabetes are prescribed this class of drugs.

“Clinical trials have provided inconsistent findings regarding the risk of heart failure with these drugs,” said lead author Kristian B. Filion, PhD, an epidemiologist at the Lady Davis Institute at the Jewish General Hospital in Montreal and assistant professor of medicine at McGill University. “By using health records from multiple Canadian provinces, the United States, and the United Kingdom, we were able to study this potential drug safety issue in a large number of patients seen in a real world setting.”

Conducting the study was the Canadian Network for Observational Drug Effect Studies (CNODES), which is funded by the Canadian Institutes of Health Research (CIHR). Researchers reviewed administrative electronic health records of more than 1.4 million patients in the three countries.

Results indicate that 29,741 of the patients were hospitalized for heart failure, representing an incidence rate of 9.2 events per 1000 persons per year. The study finds that the rate of hospitalization for heart failure did not increase with the use of incretin-based drugs as compared with oral antidiabetic-drug combinations among patients with a history of heart failure (hazard ratio, 0.86), or among those without a history of heart failure (hazard ratio, 0.82). DPP-4 inhibitors and GLP-1 analogues had similar results.

“In this analysis of data from large cohorts of patients with diabetes, incretin-based drugs were not associated with an increased risk of hospitalization for heart failure, as compared with commonly used combinations of oral antidiabetic drugs,” study authors conclude.

“There have been concerns of the potential risk of heart failure caused by this new class of diabetes medication,” co-author Jacob Udell, MD, explained in a McGill University press release. “Our study showed, when added on top of the standard of care in the real world, that these new sugar lowering drugs do not raise the risk of heart failure compared with other options in our medicine cabinet. This is reassuring news for the millions of patients with diabetes at risk for heart disease we see every day who need blood sugar control.”

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