DPP-4 Inhibitors May Be Cardioprotective

This meta-analysis offers some reassurance to those of us who continue to be concerned about the cardiovascular safety of any drug. When we get all the data for the DPP-4–inhibitor trials and the GLP-1 analogues, and examine cardiovascular events for these outcomes, we’ll know much more. But we are getting preclinical data that look positive, so we’re moving in the right direction.

The preclinical data suggest that the DPP-4 inhibitors may act directly on the heart, induce vasodilation, and improve endothelial function. But right now, we cannot separate those benefits from the improved metabolic profile that the drugs induce, so I don’t want to raise hopes too much.

Carolyn Deacon, M.D., is a medical physiologist at Panum Institute in Copenhagen. She disclosed a number of relationships with pharmaceutical companies involved in diabetes research. Her spouse is an employee of Merck.