Cardiovascular risk/benefit profiles of pioglitazone and the SGLT2 inhibitor class are summarized, based on reports at ADA 2017.
Evaluating Cardiovascular Safety of Antidiabetic Agents: based on presentations at the American Diabetes Association 77th Scientific Sessions, June 9-13, 2017
A reduction in myocardial infarction (MI) or recurrent stoke with pioglitazone in insulin-resistant patients without diabetes mellitus (DM) was evident even in patients who did not achieve standard prevention strategy goals.
Conclusion: The contribution of pioglitazone on reducing risk for recurrent stroke or MI after stroke among insulin-resistant, non-DM patients appeared independent of whether standard, evidence-based prevention strategies are achieved. Link to Abstract.
A comparison of canagliflozin (CANA) to other antidiabetic agents (DPP-4 inhibitor, sulfonylurea, GLP-1 agonist) in the routine care of patients with type 2 diabetes revealed a similar risk of coronary disease or stroke, but a lower risk of heart failure.
Conclusion: Canaglifozin use was associated with a similar risk of coronary disease or stroke as with non-gliflozin antidiabetic agents, but with a lower risk of heart failure. Link to Abstract.
SGLT2i is Associated with Lower Risk of Mortality and Heart Failure Compared with Other Glucose-lowering Drugs: A Three-Country Analysis
The class of sodium-glucose-cotransporter-2-inibitors (SGLT2i), including dapagliflozin, empagliflozin, and canagliflozin, was compared to other antidiabetic drugs for risk of all-cause mortality and heart failure.
Conclusion: In type 2 diabetes, treatment with an SGLT2i was associated with lower rates of all-cause mortality and of hospitalization for heart failure compared to other oral antidiabetics. Link to Abstract.
The cardiovascular safety of antihyperglycemic agents has come under increaesed scrutiny in the last decade with the FDA now requiring manufacturers of newer classes (eg, sodium-glucose-contranposrter-2 [SGLT2] inhibitors) conduct cardiovascular outcome studies as a condition of agency approval. Studies presented at the American Diabetes Association 77th Scientific Sessions last week examined cardiovascular risk profiles of the thiazolidinedione pioglitazone and the SGLT2 inhibitor canagliflozin as well as the 3 gliflozins that make up the SGLT2 inhibitor class.Â Â Trade names for generic drugs mentioned in this slide show appear below:Canagliflozin (Invokana, Janssen)Dapagliflozin (Farxiga, AstraZeneca)Empagliflozin (Jardiance, Lilly)Pioglitazone (Actos, Takeda Pharmaceuticals)Â