{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T03:15:43Z","timestamp":1764731743478,"version":"3.41.2"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Evidence on the safety of antidiabetic agents in end\u2010stage renal disease (ESRD) patients requiring dialysis, a group often excluded from randomized controlled trials, is scant. Dipeptidyl peptidase\u20104 inhibitors (DPP\u20104i), widely used for type 2 diabetes mellitus (T2DM) management in this group, have raised concerns regarding the risk of heart failure (HF). However, real\u2010world evidence on HF risk with DPP\u20104i in dialysis\u2010dependent diabetic patients is limited. We aimed to assess HF safety of DPP\u20104i compared with sulfonylureas (SU)\/meglitinides in a nationwide T2DM population with ESRD requiring dialysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A new user, active comparator cohort study employing propensity score\u2010inverse probability of treatment weighting was conducted utilizing Taiwan's nationwide healthcare claims database (2012\u20132020). Evaluated outcomes included hospitalizations for HF or cardiovascular death as the primary outcome, with major adverse cardiovascular events (MACEs), all\u2010cause mortality, and severe hypoglycemia as secondary outcomes, using weighted Cox proportional hazards models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 6882 patients initiating DPP\u20104i and 6174 starting SU\/meglitinides, with a mean age of 66.4\u2009years and 53.1% male. Initiation of DPP\u20104i versus SU\/meglitinide was not associated with increased risks of HF hospitalizations, cardiovascular death, MACEs, or all\u2010cause mortality, but was significantly tied to a 44% reduced risk of severe hypoglycemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study's findings indicate that in T2DM patients with ESRD requiring dialysis, DPP\u20104i do not elevate the risk of hospitalizations for HF, cardiovascular death, or all\u2010cause mortality, but significantly lower the risk of severe hypoglycemia compared with SUs\/meglitinides. This supports the preference for DPP\u20104i over SUs or meglitinides for managing T2DM in dialysis patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pds.70138","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T06:24:56Z","timestamp":1744352696000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Dipeptidyl Peptidase\u20104 Inhibitors and Risk of Heart Failure in Patients With Type 2 Diabetes Mellitus and End\u2010Stage Renal Disease Requiring Dialysis"],"prefix":"10.1002","volume":"34","author":[{"given":"Tzu\u2010Han","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Pharmacy National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tung\u2010Ying","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Pharmacy National Yang Ming Chiao Tung University  Taipei 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