Abstract
The last twelve months has brought lots of new information about the effects of inhibitors of dipeptidyl peptidase 4 (DPP-4), especially in the field of security and subsequently analyzing the results of the first studies evaluating cardiovascular indicators. Two publications issued in the first half of 2013 renewed controversy about the potential of incretins stimulate the proliferation of both β-cells, but also other cell lines in tissue of the pancreas.
The conclusions derived from the results of these works, however, were received with considerable reservations about relatively serious technical and methodological gaps in research projects. Based on the assessment of a number of resources granted FDA and EMA in February 2014 its opinion that the rumors of a causal link between drugs derived from incretins and pancreatitis or pancreatic cancer correspond to current scientific data.
Do Pending further information is available, consider these authorities pancreatitis only certain risks that may be associated with this form of treatment. The first of a series of studies with DPP-4 inhibitors specifically focused on the effect of these drugs on cardiovascular parameters (SAVOR, examin) indicated a neutral effect of saxagliptin and examined alogliptin on the cardiovascular system.
Understanding why the potential positive effects of DPP-4 inhibitors did not translate into a reduction in cardiovascular events, certainly has two levels. The first relates to the short time horizon of both studies (generally 2-3 years), which can occur when using agents primarily affecting glycated hemoglobin to major structural changes in large vessels.
The second level is so far little-known effects of inhibition of DPP-4 on endothelial function, additional features of the vascular wall, or participation in various tissues infarction.