Incretin-based antidiabetic drugs and heart failure

The aim of this study was to investigate the relationship between the use of incretin-based anti-diabetic drugs and the risk of hospitalization due to heart failure. The main finding of the study was that the use of these drugs is not associated with an increased risk of hospitalization due to heart failure.

There are many different types of drugs used for the treatment of diabetes (T2D). Two types of drugs are called GLP-1 receptor agonists (GLP-1 RA) such as exenatide (Byetta/Bydureon), liraglutide (Victoza, Saxenda) or lixisenatide (Lyxumia), and DPP-4 inhibitors (DPP4i) such as Sitagliptin (Januvia), Vildagliptin (Galvus), Saxagliptin (Onglyza), Linagliptin (Tradjenta).

An incretin is a gut hormone that causes the release of insulin (the hormone the controls blood glucose). GLP-1 is an incretin hormone. GLP-1 RAs act like GLP-1 hormone to cause the release of insulin. DPP-4 is an enzyme that breaks down GLP-1. DPP4i stop DPP-4 from breaking down GLP-1. This increases the amount of GLP-1 in the body. Therefore, GLP-1 RA and DPP4i are known as incretin-based drugs (IBD).

However, there have been some concerns that these IBD may be associated with an increased risk of heart complications. The association between IBD and risk of hospitalization due to heart failure (HF) is not known.

This study included 133,639 patients with type 2 diabetes. They were treated with different anti-diabetic drugs. Patients were followed for an average of 2.6 years.

There was no significant difference in heart failure rates in patients treated with IBD versus other anti-diabetic drugs. Similarly, there was no difference in rates of heart failure among those treated with GLP-1 RA compared to other anti-diabetic drugs or DPP-4i compared to other anti-diabetic drugs.

The authors concluded that IBDs are not associated with an increased risk of hospitalization for HF.

This study is based on healthcare databases. This is not the best level of evidence.