Alogliptin ups risk of heart failure exacerbation in T2D patients

In type 2 diabetes (T2D) patients with established heart failure (HF), use of alogliptin appears to contribute to an increased risk of HF exacerbation, reveals a study.

A total of 455 patients were included, with 28 hospital admissions and emergency department visits for HF exacerbation. Of the 53 patients with established HF, 14 (26.4 percent) experienced an exacerbation, while five (1.2 percent) of 402 patients with no HF history had an exacerbation. In addition, eight individuals (2 percent) developed new-onset HF.

Use of alogliptin was stopped in four patients (0.9 percent) due to HF. There was no significant difference seen in HF exacerbations between patients on alogliptin previously treated with saxagliptin (4.8 percent vs 4.2 percent; p=0.726).

In this study, the authors performed a retrospective chart review of patients prescribed alogliptin. The primary outcome was a composite number of HF hospital admissions and ED visits. Secondary outcomes included exacerbation rates among established HF patients, incidence of new-onset HF, incidence of alogliptin discontinuation due to HF, comparison of HF exacerbations between saxagliptin and alogliptin in patients with prior saxagliptin use, and evaluation of concomitant cardiotoxic medications.

“In 2016, the FDA issued a warning for saxagliptin and alogliptin regarding an increased risk of HF, potentially limiting the use of effective medications in T2D,” the authors said. “Current data and guideline recommendations regarding HF risk are conflicting, especially with alogliptin.”