Cardiovascular and renal safety profile of linagliptin demonstrated in Asian adults with type 2 diabetes,- Boehringer + Eli Lilly

Boehringer Ingelheim have announced the results of a sub-group analysis from the CAROLINA cardiovascular outcome trial focusing on Asian adults with type 2 diabetes mellitus and elevated cardiovascular risk. The findings, published in Diabetology International, demonstrated that linagliptin did not increase cardiovascular risk in this population versus glimepiride, and were in line with the results of the overall CAROLINA study population.

The prevalence of type 2 diabetes mellitus has increased rapidly in recent years within Asia. In 2019, the International Diabetes Federation estimated that over half (251 million) of the 463 million people globally with diabetes were in Southeast Asia and the Western Pacific. The prespecified CAROLINA sub-group analysis comprised 933 adults from Asia, 15.5% of the overall 6,033 participants in the CAROLINA study. Amongst the Asian participants in the CAROLINA study, treatment with linagliptin demonstrated a lower rate of hypoglycemia and lower risk for weight gain compared to treatment with glimepiride. Hypoglycemia of any severity occurred in 13.1% of Asian patients treated with linagliptin compared to 42.1% of those treated with glimepiride. Linagliptin showed modest weight reduction between the two treatment groups, with an average mean difference of –1.82 kg compared to glimepiride.

CAROLINA and CARMELINA make up the two cardiovascular outcome trials for linagliptin, providing one of the most comprehensive datasets on the long-term safety of a DPP-4-inhibitor. A sub-analysis of the CARMELINA trial, published in Diabetology International in October 2019, demonstrated that linagliptin did not increase risk for cardiovascular or kidney events compared to placebo in Asian adults with type 2 diabetes at high risk for heart and/or kidney disease. These results are consistent with findings in the overall CARMELINA study population.

See- Kadowaki T, Wang G, Rosenstock J, et al. “Effect of linagliptin, a dipeptidyl peptidase-4 inhibitor, compared with the sulfonylurea glimepiride on cardiovascular outcomes in Asians with type 2 diabetes: subgroup analysis of the randomized CAROLINA trial”. Diabetol Int. 2020. doi.org/10.1007/s13340-020-00447-5.

Inagaki N, Yang W, Watada H, et al. “Linagliptin and cardiorenal outcomes in Asians with type 2 diabetes mellitus and established cardiovascular and/or kidney disease: subgroup analysis of the randomized CARMELINA trial”. Diabetol Int. 2019. doi:10.1007/s13340-019-00412-x.