Trading Glucose Control for Hypertension: Lessons from Mother Nature
Clinical Trial News Tuesday, January 29th, 2013Clinical Diabetes: Winter 2013
Objective. Dipeptidyl peptidase-4 (DPP-4) inhibitors decrease degradation of the incretins and peptides such as substance P that may be involved in the pathogenesis of ACE inhibitor–associated angioedema. This study sought to determine the effect of DPP-4 inhibition on patients’ risk of developing clinical angioedema.
Design. The authors compared the incidence of angioedema in patients treated with the DPP-4 inhibitor vildagliptin to that of patients treated with a comparator in phase 3 randomized clinical trials. Prospectively defined angioedema-related events in these trials were adjudicated by a blinded internal medicine committee and an expert reviewer. Patients’ concurrent use of ACE inhibitors or angiotensin-receptor blockers (ARBs) was ascertained from case report forms. Odds ratios (ORs) and 95% confidence intervals (CIs) comparing the angioedema risk in vildagliptin- and comparator-treated patients were calculated for the full population as well as for the subset of patients taking ACE inhibitors or ARBs, using both an analysis of pooled data and a meta-analysis. Read More
