Previous meta-analyses evaluating the effectiveness of individual dipeptidyl peptidase-4 (DPP-4) inhibitors on the risk of heart failure (HF) were limited because of the small number of trials with direct comparisons between two treatments.

A new study published in the Value in Health investigated the relationship between DPP-4 inhibitors and the risk of HF in patients with type-2 diabetes mellitus.

In this Bayesian network meta-analysis, the primary outcome was the occurrence of HF or hospital admission for HF; 50 randomized controlled trials were selected.

The results revealed that when compared to placebo, no increased risk of HF events was seen for vildagliptin , sitagliptin, or saxagliptin. However, alogliptin was associated with a higher risk of HF. Moreover, vildagliptin and sitagliptin were associated with a significantly decreased risk of HF compared with alogliptin. Furthermore, vildagliptin had the highest probability to be the safest option with regard to the risk of HF, with a rate of 49.18%.

Hence, it was concluded that the risk of HF should be considered when prescribing DPP-4 inhibitors. The findings of this study indicated that vildagliptin may be the least harmful agent with regard to the risk of HF.