Safety outcomes analysis showed that GLP-1 agonists, compared with SGLT2 inhibitors and DPP-4 inhibitors, had a higher risk of adverse events that led patients to withdraw from the study.
The DPP-4 inhibitors were associated with increased acute pancreatitis risk, according to the safety analysis. “SGLT2 inhibitors were associated with increased risk of genital infections but not urinary tract infections. There was a high degree of heterogeneity for lower-limb amputations driven by the significant increase in events with canagliflozin but neutral effects of empagliflozin,” they said.
“Careful treatment selection may be necessary to minimize these outcomes in at-risk patients,” Dr. Zheng and his coauthors concluded.
One author reported potential conflicts of interest with Roche Diabetes, Dexcom, Medtronics Diabetes, and others. Another was supported by a grant from the British Heart Foundation. No other conflicts were reported.
SOURCE: Zheng SL et al. JAMA. 2018;319(15):1580-91.