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No Risk Seen of CHF with Incretin-Based Drugs in T2DM

A large study in the UK looked at the long-term effects of GLP-1 and DPP-4 therapy on patients’ risk of congestive heart failure….

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A population-based cohort study was conducted using the United Kingdom’s Clinical Practice Research Datalink which was linked to the Hospital Episodes Statistics database. Researchers performed a nested case-control analysis on 57,737 patients with no prior history of CHF who were newly prescribed antidiabetic drugs between January 1, 2007 and March 31, 2012. Patients that had been hospitalized for a first CHF were identified and defined as the case subjects. These select individuals were matched with up to 20 control subjects based on age, duration that they had treated their diabetes, calendar year, and length of time since they had entered the cohort study. Patients being treated with incretin-based drugs were compared with those that were being treated with 2 or more oral antidiabetic drugs. Odds Ratios (ORs) were estimated with corresponding 95% CIs of incident CHF using conditional logistic regression.

Out of all the patients included in the cohort that were followed for an average of 2.4 years, researchers identified 1,118 incident cases of hospitalized CHF, which amounted to an incidence rate of 8.1/1,000 person-years. The results of the analysis revealed that the current use of incretin-based drugs was not correlated with an increased risk of CHF (adjusted OR 0.85 [95% CI 0.62–1.16]). A secondary-analysis also indicated that there was no duration-response relationship (p trend = 0.39).

Therefore, it can be concluded that patients with type 2 diabetes taking incretin-based drugs were not shown to exhibit an increased risk of CHF. Although these findings provided reassuring evidence against this concern, researchers say that more large-scale studies need to replicate these results before completely ruling out the possibility that the use of these drugs could potentially lead to an increased risk of CHF.

Practice Pearls:

  • Incretin-based drugs were not associated with an increased risk of CHF in type 2 diabetes patients.
  • There was also no relationship between the duration of diabetes treatment with these drugs and the incidents of CHF.
  • More large scale studies need to be conducted to completely rule out CHF as a long-term side effect.

Published online on Sept 9, 2014 in Diabetes Care.