Sitagliptin in diabetic HF patients: Less mortality, more HF hospitalizations

In diabetic patients with heart failure (HF), sitagliptin use was found to have lower mortality rates but more subsequent HF hospitalizations than other therapies. Researchers noted there was no increased risk of all-cause hospitalizations, however.

Published online July 2 in the Journal of the American College of Cardiology: Heart Failure, the study from the University of Alberta in Edmonton in Canada followed 7,620 HF patients with type 2 diabetes registered in the U.S.-based Clinformatics Data Mart. Of their cohorts, only 12 percent of patients were given sitagliptin (Januvia, Merck).

Dean T. Eurich, PhD, lead author Daniala L. Weir, BSc, and colleagues found that more frequently diabetics were being given metformin or sulfonylureas (49.9 percent and 38.8 percent of patients respectively). Patients receiving sitagliptin were more likely to have had a history of ischemic heart disease or diabetic complications, higher use of ACE inhibitors/ARBs and statins, lower total cholesterol and fewer hospitalizations in the period leading up to the initial HF event.

Therapy that included sitagliptin and metformin had lower risks for mortality and all-cause hospitalization than therapies that did not include sitagliptin. Weir et al noted that combination therapies that included sitagliptin of any kind did not appear to increase risks for all-cause hospitalization or death. In fact, all sitagliptin therapies appeared to have lower risk endpoints except for those for HF-related hospitalizations.

Due to the nature of the data, the research team was unable to account for whether the sitagliptin use was related to body mass index, if indeed that would affect patient outcomes. They were also unable to account for increased HF hospitalizations through other variables. They noted that limited information exists on sitagliptin as it is a relatively new drug with low prescription frequency.

Weir et al still suggested further study and consideration of sitagliptin for use in HF patients with diabetes, as it appears to be as safe and effective as other therapies on the market.