Onglyza (Saxagliptin) Linked to Heart Failure
A study shows that using Onglyza (saxagliptin pills) to regulate blood sugar is linked to higher risks of heart failure.
About the Saxagliptin Risk
According to Medscape, saxagliptin is a selective dipeptidyl peptidase 4 (DPP-4) inhibitor sold as Onglyza and is made by AstraZeneca and Bristol-Myers Squibb. It is used to control blood sugar and is linked to higher risks of heart failure, higher levels of natriuretic peptides, a history of heart problems, and chronic kidney disease.
The link between saxagliptin and heart failure was first reported in October 2013 (in the New England Journal of Medicine). Research finds that the risk of heart failure is the highest in the first year after patients begin taking the drug.
A previous study by the Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus (SAVOR)-Thrombolysis in Myocardial Infarction (TIMI) found 3.5% of the patients on saxagliptin were hospitalized with heart failure. By comparison, 2.8% of placebo patients were hospitalized with heart failure.
Studies of most other glucose-lowering medications have either found a link between an increased risk of heart failure, or were not adequately designed to evaluate this risk. Dr. Gregg Fonarow of Ronald Reagan UCLA-Medical Center believes that the heart failure risk is increased with other medications. The current study by Dr. Scirica and his team sought to identify factors associated with the increased risk.
The U.S. Food and Drug Adminstration (FDA) announced in February 2014 that it would start reviewing the heart failure risk associated with saxagliptin.
The study suggests that physicians who put patients on medications for diabetes should closely monitor patients and determine whether other therapies that could potentially prevent and treat heart failure would be better for those patients.
Breakdown of the Saxagliptin Study
At 12 months, 1.9% of patients on saxagliptin had been hospitalized with heart failure versus 1.3% of the placebo group.
There was no significant difference in risk after that.
Patients' risk of hospitalization increased with their baseline levels of NT-proBNP, and being in the top quartile for levels of the biomarker was linked to 5.51-fold increased risk.
The mechanism through which saxagliptin might increase heart failure risk is not known.
Early-stage trials of the drug found no signal for fluid retention, weight gain, or heart failure.