DPP4i saxagliptin

 saxagliptin

Saxagliptin and Cardiovascular Outcomes in Patients with Type 2 Diabetes Mellitus

Benjamin M. Scirica, M.D., M.P.H., Deepak L. Bhatt, M.D., M.P.H., Eugene Braunwald, M.D., P. Gabriel Steg, M.D., Jaime Davidson, M.D., Boaz Hirshberg, M.D., Peter Ohman, M.D., Robert Frederich, M.D., Ph.D., Stephen D. Wiviott, M.D., Elaine B. Hoffman, Ph.D., Matthew A. Cavender, M.D., M.P.H., Jacob A. Udell, M.D., M.P.H., Nihar R. Desai, M.D., M.P.H., Ofri Mosenzon, M.D., Darren K. McGuire, M.D., Kausik K. Ray, M.D., Lawrence A. Leiter, M.D., and Itamar Raz, M.D. for the SAVOR-TIMI 53 Steering Committee and Investigators

N Engl J Med 2013; 369:1317-1326October 3, 2013DOI: 10.1056/NEJMoa1307684

METHODS

We randomly assigned 16,492 patients with type 2 diabetes who had a history of, or were at risk for, cardiovascular events to receive saxagliptin or placebo and followed them for a median of 2.1 years. 

Physicians were permitted to adjust other medications, including antihyperglycemic agents. 

The primary end point was a composite of cardiovascular death, myocardial infarction, or ischemic stroke.

CONCLUSIONS

DPP-4 inhibition with saxagliptin did not increase or decrease the rate of ischemic events, though the rate of hospitalization for heart failure was increased. 

Although saxagliptin improves glycemic control, other approaches are necessary to reduce cardiovascular risk in patients with diabetes. 

(Funded by AstraZeneca and Bristol-Myers Squibb; SAVOR-TIMI 53 ClinicalTrials.gov number, NCT01107886.)