Introduction

The dipeptidyl peptidase-4 inhibitors (DPP-4is), which belong to the class of incretin-based medications, are recommended as second or third-line therapies in guidelines for the management of type 2 diabetes mellitus. They have a favorable drug tolerability and safety profile compared to other glucose-lowering agents.

Objective

This review discusses data concerning the use of DPP-4is and their cardiovascular profile, and gives an updated comparison with the other oral glucose-lowering medications with regards to safety and efficacy. Currently available original studies, abstracts, reviews articles, systematic reviews and meta-analyses were included in the review.

Discussion

DPP4is are moderately efficient in decreasing the HbA1c by an average of 0.5% as monotherapy, and 1.0% in combination therapy with other drugs. They have a good tolerability and safety profile compared to other glucose-lowering drugs. However, there are possible risks pertaining to acute pancreatitis and pancreatic cancer.

Conclusion

Cardiovascular outcome trials thus far have proven the cardiovascular safety for ischemic events in patients treated with sitagliptin, saxagliptin, alogliptin, linagliptin and vildagliptin. Data showing increased rate of hospitalisation in the case of saxagliptin did not seem to be a class effect.

中文翻译：

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与其他口服降糖药物相比，二肽基肽酶-4抑制剂在2型糖尿病治疗中的功效和安全性。

介绍

在基于2型糖尿病的治疗指南中，建议将二肽基肽酶4抑制剂（DPP-4is）属于基于肠降血糖素的药物类别作为二线或三线疗法。与其他降糖药相比，它们具有良好的药物耐受性和安全性。

目的

这篇综述讨论了有关DPP-4is的使用及其心血管状况的数据，并就安全性和有效性与其他口服降糖药进行了比较。该评价包括当前可用的原始研究，摘要，评价文章，系统评价和荟萃分析。

讨论区

DPP4is单药治疗可有效降低HbA1c平均0.5％，与其他药物联合治疗可降低1.0％。与其他降糖药相比，它们具有良好的耐受性和安全性。但是，可能存在与急性胰腺炎和胰腺癌有关的风险。

结论

迄今为止，心血管结局试验已证明西他列汀，沙格列汀，阿格列汀，利那列汀和维格列汀治疗的患者对于缺血性事件具有心血管安全性。显示沙格列汀治疗中住院率增加的数据似乎不是分类效应。