The safety of linagliptin with regard to the risk of hospitalization for heart failure (HHF) in patients with type 2 diabetes mellitus (T2DM) as treated in routine care remains of interest. We compared the risk of HHF associated with the initiation of linagliptin vs. other antidiabetic agents. In two large commercial U.S. health insurance datasets (Optum Clinformatics and Truven MarketScan), we identified T2DM patients who initiated linagliptin, sitagliptin, saxagliptin, or sulfonylureas (SU) between 5/2011 and 9/2015 and had no previous Heart Failure (HF) history or HF treatment. We estimated hazard ratios (HR) of HHF in 3 separate propensity score matched cohorts that balanced over 130 baseline characteristics. We combined HRs via a fixed-effects meta-analysis. Mean follow-up was nearly 8 months. Linagliptin initiators had no significant difference in the risk of HHF compared with sitagliptin (HR= 0.83 [95% CI=0.58, 1.20]), saxagliptin (HR= 1.13 [0.74, 1.71]), or SU (HR= 0.71, [0.46, 1.10]). In contrast to high cardiovascular (CV) risk clinical trial populations, in a population of T2DM patients without HF history, aged 57 years on average, we did not find a difference in HHF risk between DPP-4 inhibitors with sufficient certainty. Consistent with prior studies, there may be a reduced HHF risk vs. SU; further evidence is expected from ongoing linagliptin CV outcomes trials.


E. Patorno: Research Support; Self; National Institute on Aging. Other Relationship; Self; Boehringer Ingelheim GmbH, GlaxoSmithKline plc.. M. Mahesri: None. C. Gopalakrishnan: None. K. Brodovicz: Employee; Self; Boehringer Ingelheim Pharmaceuticals, Inc. A. Meyers: Employee; Self; Boehringer Ingelheim Pharmaceuticals, Inc. D. Bartels: Employee; Self; Boehringer Ingelheim GmbH. S. Schneeweiss: Consultant; Self; WHISCON, LLC. Other Relationship; Self; Aetion, Inc.. Research Support; Self; Genentech, Inc., Bayer AG, Boehringer Ingelheim GmbH, U.S. Food and Drug Administration, Patient-Centered Outcomes Research Institute.

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