J Lipid Atheroscler.  2022 Jan;11(1):89-101. 10.12997/jla.2022.11.1.89.

Correction to: “Cardiovascular Outcomes Comparison of Dipeptidyl Peptidase-4 Inhibitors Versus Sulfonylurea as Add-on Therapy for Type 2 Diabetes Mellitus: A Meta-Analysis”

• Jeon WK
• Kang J
• Kim HS
• Park KW

• KMID: 2525229
• DOI: http://doi.org/10.12997/jla.2022.11.1.89

Abstract

Objective
Recent studies have raised concerns about the cardiovascular safety of dipeptidyl peptidase-4 (DPP4) inhibitors. We performed a systematic review and meta-analysis to compare the cardiovascular outcomes of sulfonylureas (SUs) versus DPP4 inhibitors in combination with metformin.
Methods
After searching for trials using combination therapy of metformin with an SU or DPP4 inhibitor in PubMed, Cochrane Library, and Embase, 1 prospective observational study and 15 randomized controlled studies were selected.
Results
Regarding the primary analysis endpoint, no significant differences were found in the risk of all-cause mortality between SUs and DPP4 inhibitors as add-on therapies to metformin (random-effect relative risk [RR], 1.14; 95% confidence interval [CI], 0.98–1.33; I² =0%; p=0.097). Cardiovascular death was also similar between SUs and DPP4 inhibitors in the 5 studies that reported outcomes (random-effect RR, 1.03; 95% CI, 0.83–1.27; I² =0%; p=0.817). Furthermore, there were no significant differences in major adverse cardiac events, coronary heart disease, myocardial infarction, and heart failure. However, the SU group showed a higher risk of ischemic stroke, more hypoglycemic events, and more weight gain than the DPP4 inhibitor group (ischemic stroke, random-effect RR, 2.78; 95% CI, 1.06–7.30; I² =51.9%; p=0.039; hypoglycemia, random-effect RR, 3.79; 95% CI, 1.53–9.39; I² =98.2; p=0.004; weight gain, weighted mean difference, 1.68; 95% CI, 1.07–2.29; I² =94.7; p<0.001).
Conclusion
As add-on therapies to metformin, SUs and DPP4 inhibitors showed no significant differences in all-cause mortality and cardiovascular mortality. However, some of the favorable results of DPP4 inhibitors suggest good safety and feasibility of the drugs.

Keyword

Diabetes mellitus; Sulfonylurea compounds; DPP4 inhibitor; Cardiovascular risk