Sulphonylureas and risk of cardiovascular disease: systematic review and meta‐analysis

Phung, Olivia J; Schwartzman, Emmanuelle; Allen, Robert W.; Engel, Samuel S.; Rajpathak, Swapnil

doi:10.1111/dme.12232

Cited by 139 publications

(99 citation statements)

References 49 publications

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“…Despite the similarities between these sulfonylureas, they have different extra pancreatic effects and may have different effects on cardiovascular disease. However, their effects on cardiovascular disease remain unclear [32].…”

Section: Discussionmentioning

confidence: 99%

“…Although it remains unclear whether the administration of sulfonylureas impedes cardiovascular disease onset, which is the endpoint [32], the outcomes of the present study, i.e., blood PAI-1 levels, could serve as a surrogate marker for cardiovascular disease onset [3]. In the present study, glib-doi: 10.7243/2050-0866-7-1 enclamide, gliclazide, and glimepiride were compared with the placebo, and no significant decrease in blood PAI-1 levels was observed after using the agents.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of sulfonylurea treatment on blood plasminogen activator inhibitor-1 levels in patients with type 2 diabetes mellitus: A network meta-analysis

Ida¹,

Murata²,

Kaneko³

2018

J Diab Res Clin Met

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Background: To compare the effects ofthree types of sulfonylureas (glibenclamide, gliclazide, and glimepiride) on blood plasminogen activator inhibitor-1 levels in patients with type2 diabetes mellitus, a network meta-analysis of randomized controlled trialswas performed. Methods: A literature search using MEDLINE, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov was conducted. Randomized controlled trialsin which the effects of sulfonylureas on blood plasminogen activator inhibitor-1 levels in patients with type 2 diabetes mellitus were evaluated were includes. Outcome assessment included standardized mean differences and 95% confidence intervals. Results: Twelve randomized controlled trials (1,050 subjects) met the inclusion criteria and were included in the network meta-analysis. No significant difference was observedin blood plasminogen activator inhibitor-1 levels after using a placebo compared with those after using glibenclamide, gliclazide, and glimepiride. Blood plasminogen activator inhibitor-1levels were significantly lower after using gliclazide than after using glimepiride (standardized mean difference: -0.52; 95% confidence interval: -0.99%-0.44%). However, no significant difference was observed in blood plasminogen activator inhibitor-1 levels after using glibenclamide compared with those after using gliclazide and glime piride. Conclusions: Regarding the use of sulfonylureas for treating patients with type 2 diabetes mellitus, gliclazide may be preferable because of low blood plasminogen activator inhibitor-1 levels after its use. However, few studies have been published on the use of gliclazide, and the quality of these studies has been generally poor; thus, the results of this study should be interpreted with caution.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of sulfonylurea treatment on blood plasminogen activator inhibitor-1 levels in patients with type 2 diabetes mellitus: A network meta-analysis

Ida¹,

Murata²,

Kaneko³

2018

J Diab Res Clin Met

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show abstract

“…However, some of the newer shorter-acting antidiabetic sulfonylureas, such as gliclazide and glimepiride, do not appear to interfere with cardioprotection (Wu et al, 2007). A recent metaanalysis has confirmed that sulphonylurea use may elevate the risk of cardiovascular disease among patients with diabetes (Phung et al, 2013), although one long-term clinical outcome study failed to report any increase in cardiovascular events in diabetic patients treated with glibenclamide compared with gliclazide (Juurlink et al, 2012).…”

Section: Antidiabetic Therapymentioning

confidence: 99%

Interaction of Risk Factors, Comorbidities, and Comedications with Ischemia/Reperfusion Injury and Cardioprotection by Preconditioning, Postconditioning, and Remote Conditioning

Ferdinándy¹,

Hausenloy²,

Heusch³

et al. 2014

Pharmacol Rev

516

501

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“…Indeed, several recent studies suggested that patients treated with sulfonylureas have increased cardiovascular morbidity compared with patients treated with metformin [45][46][47] . Therefore, it would be of interest to compare the effects of prior treatment of DPP-4 inhibitors with prior treatment with metformin in experimental models of stroke or in patients who suffer a stroke.…”

Section: Ref Design N Agent Resultsmentioning

confidence: 99%

Antidiabetic treatment, stroke severity and outcome

Magkou¹,

Τζιόμαλος²

2014

WJD

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Ischemic stroke is a leading cause of mortality and long-term disability worldwide. Given the detrimental effects of acute stroke, several neuroprotective agents have been evaluated in these patients. However, the benefits of the evaluated agents appear to be limited and none is currently recommended for clinical use. On the other hand, prior treatment with agents that are used for the primary and secondary prevention of stroke, including statins and antiplatelets, has been associated with better outcome in patients who experience an acute stroke. In contrast, there are limited data as to whether prior treatment with antidiabetic agents is beneficial in diabetic patients who suffer a stroke. In this context, the findings of a recent study that showed reduced stroke size following pretreatment with linagliptin, a dipeptidyl peptidase-4 (DDP-4) inhibitor, compared with glimepiride, in both diabetic and non-diabetic mice, appear promising. Despite these preclinical findings suggesting neuroprotective effects of DPP-4 inhibitors in acute stroke, it is still unclear whether these actions will also be observed in humans. Of note, two recent large randomized, placebo-controlled studies did not show any effect of DPP-4 inhibitors on cardiovascular events, including stroke. Several other ongoing trials are evaluating the effects of DPP-4 inhibitors on cardiovascular morbidity and mortality. These studies also provide a major opportunity to assess whether patients treated with this class of antidiabetic agents will suffer from less severe strokes and whether their outcome after stroke will be more favorable.© 2014 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Type 2 diabetes mellitus; Stroke; Dipeptidyl peptidase-4 inhibitors; Sulfonylureas; Neuroprotection Core tip: A recent study showed reduced stroke size following pretreatment with linagliptin, a dipeptidyl peptidase-4 (DDP-4) inhibitor, compared with glimepiride, in both diabetic and non-diabetic mice. It remains to be shown whether these neuroprotective actions of DPP-4 inhibitors will also be observed in humans.Magkou D, Tziomalos K. Antidiabetic treatment, stroke severity and outcome. World J Diabetes 2014; 5(2): 84-88 Available from:

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Sulphonylureas and risk of cardiovascular disease: systematic review and meta‐analysis

Cited by 139 publications

References 49 publications

Effects of sulfonylurea treatment on blood plasminogen activator inhibitor-1 levels in patients with type 2 diabetes mellitus: A network meta-analysis

Effects of sulfonylurea treatment on blood plasminogen activator inhibitor-1 levels in patients with type 2 diabetes mellitus: A network meta-analysis

Interaction of Risk Factors, Comorbidities, and Comedications with Ischemia/Reperfusion Injury and Cardioprotection by Preconditioning, Postconditioning, and Remote Conditioning

Antidiabetic treatment, stroke severity and outcome

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