[Cardiovascular safety of non-insulin anti-diabetic drugs. Scientific position statement of SEMERGEN]

Abstract

Diabetes increases the risk of both microvascular and macrovascular complications. Although reducing plasma glucose levels to recommended targets decreases the risk of microvascular outcomes, the effects of anti-diabetic drugs on macrovascular complications and cardiovascular death are of concern. In fact, it has been suggested that some anti-diabetic agents could even be harmful for cardiovascular outcomes. In this context, several health care regulatory agencies have established the need for performing clinical trials specifically designed to assess the cardiovascular safety of anti-diabetic drugs. The results of 2 clinical trials have recently been published that provide important information on the cardiovascular safety of dipeptidyl peptidase 4 (DPP-4) inhibitors. The aim of this document was to review the available evidence on the cardiovascular safety of non-insulin anti-diabetic drugs and provide practical recommendations on their use in this context.

Keywords: Agonistas receptores GLP-1; Alpha-glucosidase inhibitors; Anti-diabetic drugs; Antidiabéticos; Biguanidas; Biguanides; Cardiovascular safety; DPP-4 inhibitors; Diabetes; EXAMINE; GLP-1 receptor agonists; Inhibidores DPP-4; Inhibidores SGLT2; Inhibidores de la alfa glucosidasa; Meglitinidas; Meglitinides; SAVOR-TIMI 53; SGLT2 inhibitors; Seguridad cardiovascular; Sulfonilureas; Sulfonylureas; Thiazolidinediones; Tiazolidindionas.