Skip to main content

Advertisement

Log in

Diabetes

Metformin — a cardiovascular moderator of DPP4 inhibitors?

  • News & Views
  • Published:

From Nature Reviews Endocrinology

View current issue Sign up to alerts

Three cardiovascular outcome trials failed to show superiority of DPP4 inhibitors compared with placebo in patients with type 2 diabetes mellitus and high cardiovascular risk, a rather disappointing finding. Now, a post hoc subgroup analysis suggests that patients treated with metformin at baseline might benefit from DPP4 inhibitors in contrast with metformin non-users.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Scheen, A. J. Cardiovascular effects of gliptins. Nat. Rev. Cardiol. 10, 73–84 (2013).

    Article  CAS  Google Scholar 

  2. Standl, E. et al. Integration of recent evidence into management of patients with atherosclerotic cardiovascular disease and type 2 diabetes. Lancet Diabetes Endocrinol. 5, 391–402 (2017).

    Article  Google Scholar 

  3. White, W. B. et al. Alogliptin after acute coronary syndrome in patients with type 2 diabetes. N. Engl. J. Med. 369, 1327–1335 (2013).

    Article  CAS  Google Scholar 

  4. Scirica, B. M. et al. Saxagliptin and cardiovascular outcomes in patients with type 2 diabetes mellitus. N. Engl. J. Med. 369, 1317–1326 (2013).

    Article  CAS  Google Scholar 

  5. Green, J. B. et al. Effect of sitagliptin on cardiovascular outcomes in type 2 diabetes. N. Engl. J. Med. 373, 232–242 (2015).

    Article  CAS  Google Scholar 

  6. Crowley, M. J. et al. Metformin use may moderate the effect of DPP-4 inhibitors on cardiovascular outcomes. Diabetes Care http://dx.doi.org/10.2337/dc17-1528 (2017).

  7. Hernandez, A. V. et al. Subgroup analyses in therapeutic cardiovascular clinical trials: are most of them misleading? Am. Heart J. 151, 257–264 (2006).

    Article  Google Scholar 

  8. Sun, X. et al. How to use a subgroup analysis: users' guide to the medical literature. JAMA 311, 405–411 (2014).

    Article  CAS  Google Scholar 

  9. Migoya, E. M. et al. Dipeptidyl peptidase-4 inhibitors administered in combination with metformin result in an additive increase in the plasma concentration of active GLP-1. Clin. Pharmacol. Ther. 88, 801–808 (2010).

    Article  CAS  Google Scholar 

  10. Wang, F. et al. Combination therapy of metformin plus dipeptidyl peptidase-4 inhibitor versus metformin plus sulfonylurea and their association with a decreased risk of cardiovascular disease in type 2 diabetes mellitus patients. Medicine (Baltimore) 96, e7638 (2017).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to André J. Scheen.

Ethics declarations

Competing interests

The author declares that no competing interests are directly relevant to the content of this manuscript. A.J.S. has received lecturer,scientific adviser and clinical investigator fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck Sharp & Dohme, NovoNordisk, Sanofi and Servier. A.J.S. was a clinical investigator in the TECOS, LEADER, EMPA-REG OUTCOME and CANVAS-R trials.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Scheen, A. Metformin — a cardiovascular moderator of DPP4 inhibitors?. Nat Rev Endocrinol 14, 8–9 (2018). https://doi.org/10.1038/nrendo.2017.154

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrendo.2017.154

  • Springer Nature Limited

This article is cited by

Navigation