Potential effects of vildagliptin on cardiovascular disease

Fonseca, Vivian
January 2013
Hot Topics in Cardiometabolic Disorders;2013, Vol. 3 Issue 5, p7
Dipeptidyl peptidase-4 (DPP-4) inhibitors have been approved for the treatment of hyperglycemia. In clinical studies they showed good efficacy on glucose control, good safety and good patient tolerance. Yet their impact on cardiovascular risks factors and on cardiovascular events has not been deeply investigated. Weight gain or an increased rate of hypoglycemia may negatively affect the cardiovascular system; however, published data on vildagliptin and other DPP-4 inhibitors demonstrated neutral effects on those factors, and thus no increased cardiovascular risk. Some animal and human studies have suggested a potential cardioprotective effect of DPP-4 inhibitors, although those investigations were often short-term mechanistic studies. For example, data on vildagliptin indicate a potential role in reducing infarct size, a protective action against vascular injury in diabetes, or a slight effect on blood pressure, but these need to be confirmed by larger clinical trials. The effects on lipids are equally encouraging. A meta-analysis showed that treatment with DPP-4 inhibitors was associated with small reductions in total cholesterol and plasma triglycerides. Data on vildagliptin monotherapy confirmed that its efficacy is similar to that observed for all drugs considered together. Furthermore, meta-analyses considering the occurrence of cardiovascular events with DPP-4 inhibitors, and vildagliptin in particular, demonstrated potential benefits in terms of reducing cardiovascular events. Although DPP-4 inhibitors exhibited interesting cardioprotective effects, results from larger and long-term studies are needed for definitive conclusions.


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