Novel pharmacological therapy in type 2 diabetes mellitus with established cardiovascular disease: Current evidence

Table 1 Summary of dipeptidyl peptidase 4 cardiovascular outcome trials

Trial	NumberFollow up	CVD (baseline)	Characteristics (baseline)	Drug vs Placebo (%) PEP	Superiority
SAVOR-TIMI53 (Saxagliptin) 2013	n = 16492, 2.1 yr (median)	Pre-existing CV or high CV risk/multiple CV risk factors	65 y/o, DM duration: 10 yr; A1c: 8%; BMI: 31	7.3 vs 7.2	No
EXAMINE (Alogliptin) 2013	n = 5380, 1.5 yr (median)	Acute MI or HUA in previous 15 to 90 d	61 y/o, DM duration: 7 yr; A1c: 8%; BMI: 29	11.3 vs 11.8	No
TECOS (Sitagliptin) 2015	n = 14671, 3.1 yr (median)	Pre-existing CV disease (CAD, ischemic stroke, PAD)	65.5 y.o, DM duration: 11.6 yr; A1c: 7.2%; BMI: 30.2	11.4 vs 11.6 (4-point MACE)	No

Note, as a class dipeptidyl peptidase 4 inhibitor has no data for significant reduction in cardiovascular endpoints. The TECOS trial had a 4-point MACE, consisting of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke or hospitalization for unstable angina. DPP4: Dipeptidyl peptidase 4; CVOT: Cardiovascular outcome trial; CVD: Cardiovascular disease; PEP: Primary end point; BMI: Body mass index; HUA: Hospitalization due to unstable angina; MI: Myocardial infarctions; PAD: Peripheral artery disease; CAD: Coronary artery disease; MACE: Major cardiovascular events.