{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:00:01Z","timestamp":1790373601058,"version":"4.1.0"},"reference-count":46,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Endocrino Diabet &amp; Metabol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>DPP\u20104 inhibitors use has been reported to cause heart failure events in patients with type\u20102 diabetes. The FDA had also issued warnings concerning increased risk of heart failure events for alogliptin, saxagliptin and their combination with metformin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Randomized controlled trials (RCTs) involving adult patients with type\u20102 diabetes patients with or without history of cardio\u2010vascular disorders were included in the review. Cohort studies, case\u2013control studies and other non\u2010RCTs, and studies involving paediatric patients were excluded. Data bases searched were PubMed\/Medline, DOAJ, MDPI, Google Scholar and\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrails.gov\">clinicaltrails.gov<\/jats:ext-link>\n                      . The search was conducted in late January of 2026. Risk of bias was assessed using RoB\u20102 tool for RCTs. Individual study outcomes were tabulated and summary measure was synthesized by meta\u2010analysis under random effect model; GRADE certainty of evidence was used; sub\u2010group analysis based on individual DPP\u20104 inhibitors, follow\u2010up duration and placebo or other controls was done; systematic review was done under PRISMA 2020 Guidelines.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The meta\u2010analysis was done under random effect computation model for all 29 included studies. The analysis for total of pooled 67,873 patients showed statistically insignificant association between the use of DPP\u20104 inhibitors and heart failure with Risk Ratio (RR)\u2009=\u20091.06, 95% Confidence Interval (CI) 0.94\u20131.12. Sub\u2010group analysis found significant association of saxagliptin use with increased heart failure risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Results should be interpreted with caution because of several limitations of the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>PROSPERO, CRD420261288081<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/edm2.70316","type":"journal-article","created":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T07:27:49Z","timestamp":1787124469000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dipeptidyl Peptidase\u20104 Inhibitors Associated Heart Failure Events in Adult Patients With Type\u20102 Diabetes Mellitus Treated With Dipeptidyl Peptidase\u20104 Inhibitors: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0280-1411","authenticated-orcid":false,"given":"Shishir","family":"Nepal","sequence":"first","affiliation":[{"name":"Faculty of Medical Sciences Pokhara Academy of Health Sciences  Pokhara Gandaki Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4022-3271","authenticated-orcid":false,"given":"Shiva Prasad","family":"Nepal","sequence":"additional","affiliation":[{"name":"Faculty of Management Tribhuvan University  Kirtipur Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0891\u20108422(03)00082\u2010X"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.7748\/ns.2021.e11709"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2023.115734"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1440456"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/DDDT.S37647"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.70277"},{"key":"e_1_2_12_8_1","volume-title":"StatPearls [Internet]","author":"Kasina S. 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