Cardiovascular Effects of Alogliptin, Linagliptin, Saxagliptin, and Sitagliptin: A Target Trial Emulation of a Comparative Effectiveness Study
Authors' conclusion
Risks of MACE, HHF, and hypoglycemia were comparable with all DPP4i.
Study context
- Population
- Adults (≥21 years) with T2D, moderate cardiovascular risk, not requiring insulin, initiating a DPP-4i; commercial, Medicare Advantage and traditional Medicare claims 2014–2021
- Participants
- 2,541 / 42,433 / 15,649 / 124,038
- Comparison
- Alogliptin vs linagliptin vs saxagliptin vs sitagliptin
- Alogliptinn = 2,541
- Linagliptinn = 42,433
- Saxagliptinn = 15,649
- Sitagliptinn = 124,038reference
- Outcome
- Major adverse cardiovascular event (MACE):
- MI
- Stroke
- All-cause mortality
Methodological detailsclaims data, propensity scores (super learner ensemble), inverse probability of treatment weighting, Cox models
- Claims data
- Propensity scores (super learner ensemble)
- Inverse probability of treatment weighting
- Cox models
Main finding
As reported in the abstract
MACE · 1 year
Hazard ratio (95% CI)
Saxagliptinvs Sitagliptin
0.94(0.88–0.99)
Saxagliptinvs Linagliptin
0.94(0.87–1.00)
Further findings
HHF · 1 year
Median weighted follow-up
HHF · 1 year
- No significant difference in HHF risk among the study drugs
Safety
Hypoglycemia requiring ED/hospital use · 1 year
Hypoglycemia requiring ED/hospital use · 1 year
- No significant difference in hypoglycemia risk among the study drugs
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Cardiovascular Effects of Alogliptin, Linagliptin, Saxagliptin, and Sitagliptin: A Target Trial Emulation of a Comparative Effectiveness Study. Endocr Pract. Published 8 April 2026. doi:10.
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