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Rev Med Suisse. 2018 Aug 22;14(615):1468-1472.

[Cardiovascular safety of DPP-4 inhibitors compared to that of sulfonylureas].

[Article in French; Abstract available in French from the publisher]

Author information

Service de diabétologie, nutrition et maladies métaboliques, CHU Liège, 4000 Liège, et Unité de pharmacologie clinique, Centre interdisciplinaire de recherche du médicament (CIRM), Liège Université, 4000 Liège, Belgique.


in English, French

After metformin monotherapy, the choice between a sulfonylurea and a dipeptidyl peptidase-4 (DPP-4) inhibitor may be critical in clinical practice. This article compares the cardiovascular safety of these two pharmacological classes based on meta-analyses of randomized controlled trials and observational studies. Both approaches show a better cardiovascular safety with DPP-4 inhibitors than with sulfonylureas. However, some heterogeneity exists, most probably explained by differences between the molecules, especially among sulfonylureas as those of last generation (more particularly gliclazide) seem to have a better safety profile. The ongoing head-to-head prospective trial CAROLINA compares the cardiovascular safety of glimepiride and linagliptin in high-risk patients, with results expected in 2019.

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