Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

CAROLINA findings reaffirm linagliptin’s safety, free glimepiride of CV-risk stigma

Key clinical point: Linagliptin and the sulfonylurea glimepiride did not increase cardiovascular risk in patients with type 2 diabetes and increased risk for cardiovascular events, although concerns remain about glimepiride-related hypoglycemia and weight gain.

Major finding: After a median follow-up of 6.3 years, there was no difference between linagliptin and glimepiride in the primary composite outcome of cardiovascular death, nonfatal myocardial infarction, and nonfatal strokes (11.8% and 12%, respectively; P = .76).

Study details: More than 6,000 patients with type 2 diabetes were evenly randomized to linagliptin 5 mg daily or glimepiride 1-4 mg daily.

Disclosures: Boehringer Ingelheim, the maker of linagliptin, funded the study in collaboration with comarketer, Eli Lilly. Dr. Rosenstock and Dr. Marx disclosed ties to Boehringer Ingelheim and Eli Lilly, and other companies not associated with the study. Dr. Eckel disclosed ties with pharma companies, but they were not associated with the study.


Rosenstock J et al. ADA 2019.