Settled
Do DPP-4 inhibitors improve cardiovascular events versus placebo?
Mostly studied in type 2 & unspecified diabetes.
Not modeled yetTrial evidence exists, but no mechanistic model yetWithout a model there is no decisive experiment to propose. Help build it. →
Where the evidence stands
Very likely. So far, repeated by independent trials.
NoUnsureYes
- Belief
- 0.99 (range 0.84–1.00)
- Trials for
- 2
- Trials against
- 0
- Inconclusive
- 1
Already under way
- Comparative Effectiveness of Oral Semaglutide vs Sitagliptin Among Individuals With Heart Failure With Preserved Ejection Fraction (STEP-HFpEF DM ORAL)NCT07390110 · active not recruiting · started 2026
- A Multicenter, Prospective, Non-interventional Observation Study to Evaluate the Safety and Effectiveness of OAD Triple Therapy in Korean Type 2 Diabetic…NCT06838286 · recruiting · started 2024
- Comparative Effectiveness and Safety of Four Second Line Pharmacological Strategies in Type 2 Diabetes StudyNCT05220917 · active not recruiting · started 2021
- Impact of Sodium-Glucose Cotransporter 2 (SGLT2) Inhibitor Use After Acute Myocardial Infarction in Patients With Type 2 Diabetes: A Nationwide Population…NCT07198191 · active not recruiting · started 2014
The evidence so far
- Registered trials
- 36
- With posted results
- 6
- Published papers
- 7
Of 7 decided analyses: 3 favor dpp-4 inhibitors, 4 find no difference, 0 favor the comparator.
Papers
- Alogliptin in Patients with Type 2 Diabetes Receiving Metformin and Sulfonylurea Therapies in the EXAMINE Trial.Trial report · 2018
- Comparative effect of saxagliptin and glimepiride with a composite endpoint of adequate glycaemic control without hypoglycaemia and without weight gain in patients uncontrolled with metformin therapy: Results from the SPECIFY study, a 48-week, multi-centre, randomized, controlled trial.Trial report · 2019
- Metformin Use May Moderate the Effect of DPP-4 Inhibitors on Cardiovascular Outcomes.Meta-analysis / systematic review · 2017
- RETRACTED: Cardiovascular and mortality outcomes of DPP-4 inhibitors vs. sulfonylureas as metformin add-on therapy in patients with type 2 diabetes: A systematic review and meta-analysis.Meta-analysis / systematic review · 2025
- 2-year efficacy and safety of linagliptin compared with glimepiride in patients with type 2 diabetes inadequately controlled on metformin: a randomised, double-blind, non-inferiority trial.Trial report · 2012
- Managing glycaemia in older people with type 2 diabetes: A retrospective, primary care-based cohort study, with economic assessment of patient outcomes.Observational study · 2017
Trials
- A Randomised, Double-blind, Double-dummy, Active-comparator Controlled Study Investigating the Efficacy and Safety of Linagliptin Co-administered With Metformin QD at Evening Time Versus Metformin BID Over 14 Weeks in Treatment Naive Patients With Type 2 Diabetes Mellitus and Insufficient Glycaemic ControlNCT01438814 · 4 posted results
- The Effect of Adding Vildagliptin Versus Glimepiride to Metformin on Markers of Inflammation, Thrombosis, and Atherosclerosis in Diabetic Patients With Symptomatic Coronary Artery DiseasesNCT03693560
- Effects of Vildagliptin/Metformin Combination on Markers of Atherosclerosis, Thrombosis, and Inflammation in Diabetic Patients With Coronary Artery DiseaseNCT01604213
- Comparison of Type 2 Diabetes Pharmacotherapy Regimens Using Targeted LearningNCT05073692 · 1 posted result
- Sodium-glucose Cotransporter 2 (SGLT2) Inhibitors and the Risk of Cardiovascular Events Among Patients With Type 2 Diabetes: a Multicenter Cohort StudyNCT03939624
- BESTMED: Observational Evaluation of Second Line Therapy Medications in DiabetesNCT05161429
- Safety of Sodium-glucose Cotransporter 2 (SGLT2) Inhibitors Among Patients With Type 2 Diabetes: a Multicenter Cohort StudyNCT04017221
- Efficacy and Safety of Semaglutide Once-weekly Versus Sitagliptin Once-daily as add-on to Metformin in Subjects With Type 2 Diabetes. A 30-week Randomised, Double-blind, Double-dummy, Active-controlled, Parallel-group, Multi-centre and Multi-national TrialNCT03061214 · 1 posted result