Key result
Targeting the DPP-4-GLP-1 pathway with DPP-4 inhibitors or GLP-1 receptor agonists improved exercise tolerance in heart failure patients (MD 24.88) without decreasing quality of life.
Why the study?
Exercise intolerance is the most significant manifestation of heart failure, and it remained to be investigated whether DPP-4 inhibitors or GLP-1 RAs could improve exercise tolerance in heart failure patients with or without type 2 diabetes mellitus.
Does targeting the DPP-4-GLP-1 pathway with DPP-4 inhibitors or GLP-1 RAs improve exercise tolerance in heart failure patients with or without type 2 diabetes mellitus?
Meta-Analysis (n=659)
Does targeting the DPP-4-GLP-1 pathway with DPP-4 inhibitors or GLP-1 RAs improve exercise tolerance in heart failure patients with or without type 2 diabetes mellitus?
Targeting the DPP-4-GLP-1 pathway with GLP-1 RAs or DPP-4 inhibitors significantly improves exercise tolerance in patients with heart failure, without adversely affecting quality of life or increasing serious adverse events.
Answers are grounded in this paper and cite their sources.
Supports incretin therapies to boost exercise capacity in heart failure; extends evidence to patients with or without diabetes.
BACKGROUND: The most significant manifestation of heart failure is exercise intolerance. This systematic review and meta-analysis was performed to investigate whether dipeptidyl peptidase-4 (DPP-4) inhibitors or glucagon-like peptide 1 receptor agonists (GLP-1 RAs), widely used anti-diabetic drugs, could improve exercise tolerance in heart failure patients with or without type 2 diabetes mellitus. METHODS: consumption], and the secondary outcomes included quality of life (QoL), adverse events (AEs) and all-cause death. RESULT: After the literature was screened by two reviewers independently, four trials (659 patients) conducted with heart failure patients with or without type 2 diabetes met the eligibility criteria. The results suggested that targeting the DPP-4-GLP-1 pathway can improve exercise tolerance in heart failure patients [MD 24.88 (95% CI 5.45, 44.31), P = 0.01] without decreasing QoL [SMD -0.51 (95% CI -1.13, 0.10), P = 0.10]; additionally, targeting the DPP-4-GLP-1 pathway did not show signs of increasing the incidence of serious AEs or mortality. CONCLUSION: Our results suggest that DPP-4 inhibitors or GLP-1 RAs improve exercise tolerance in heart failure patients. Although the use of these drugs for heart failure has not been approved by any organization, they may be a better choice for type 2 diabetes mellitus patients with heart failure. Furthermore, as this pathway contributes to the improvement of exercise tolerance, it may be worth further investigation in exercise-intolerant patients with other diseases.
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Chen et al. (2019) conducted a meta-analysis in Heart failure with or without type 2 diabetes mellitus (n=659). DPP-4 inhibitors or GLP-1 receptor agonists vs. Placebo or active control (insulin glargine) was evaluated on Exercise tolerance (6-minute walk test) (MD 24.88, 95% CI 5.45, 44.31, p=0.01). Targeting the DPP-4-GLP-1 pathway with DPP-4 inhibitors or GLP-1 receptor agonists improved exercise tolerance in heart failure patients (MD 24.88) without decreasing quality of life.
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