Clinical Edge

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Sulfonylureas and Cardiac Outcomes Evaluated

Diabetes Care; ePub 2018 Feb 2; Leonard, et al

Patients who take glyburide may be less likely than those receiving glipizide to experience sudden cardiac arrest (SCA) and ventricular arrhythmia (VA), according to a retrospective cohort study involving >500,000 individuals. Participants’ average age was 58 years. Investigators analyzed 1999–2010 Medicaid claims from 5 large states, looking at SCA/VA incidence in patients who took glyburide, glimepiride, or glipizide. Among the results:

  • 632 SCA/VA events were seen in ~177,000 person-years of sulfonylurea exposure.
  • >Half of the events were immediately fatal (3.6/1,000 person-years).
  • Patients taking glyburide were 18% less likely to experience SCA/VA compared with those who took glipizide.
  • Patients taking glimepiride were 10% more likely to experience such.

The authors noted that it is important to also consider the effects different sulfonylureas have on other cardiovascular and cerebrovascular outcomes, all-cause death, and hypoglycemia.

Citation:

Leonard C, Brensinger C, Aquilante C, et al. Comparative safety of sulfonylureas and the risk of sudden cardiac arrest and ventricular arrhythmia. [Published online ahead of print February 2, 2018]. Diabetes Care. doi:10.2337/dc17-0294.

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