- Trajenta demonstrates no increased cardiovascular risk compared to glimepiride in adults with type 2 diabetes and cardiovascular risk
- With a median follow-up of more than 6 years, CAROLINA adds evidence to the long-term safety profile of Trajenta in a broad range of adults with type 2 diabetes
Boehringer Ingelheim and Eli Lilly and Company (NYSE: LLY) announced CAROLINA (CARdiovascular Outcome study of LINAgliptin versus glimepiride in patients with type 2 diabetes) met its primary endpoint, defined as non-inferiority of Trajenta (linagliptin) vs glimepiride in time to first occurrence of cardiovascular death, non-fatal myocardial infarction or non-fatal stroke (3P-MACE).1,2
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CAROLINA is the only active-comparator cardiovascular outcome trial for a dipeptidyl peptidase-4 (DPP-4) inhibitor.1,2 The trial evaluated the cardiovascular safety of linagliptin (5 mg once daily) compared to the sulphonylurea glimepiride, on top of standard of care in 6,033 adults with type 2 diabetes and increased cardiovascular risk or established cardiovascular disease.1,2 The trial assessed linagliptin safety over the longest period ever studied in a DPP-4 inhibitor cardiovascular outcome trial, with a median follow-up of more than 6 years.1,2 The overall safety profile of linagliptin in CAROLINA was consistent with previous data and no new safety signals were observed.3
People who have type 2 diabetes are at an increased risk of cardiovascular disease and, despite recent advancements in treatment options, cardiovascular disease remains the leading cause of death for this population.4 Together with CARMELINA, the placebo-controlled cardiovascular outcome trial, which demonstrated long-term cardiovascular safety in adults with type 2 diabetes at high risk for heart and kidney disease,5 CAROLINA confirms linagliptin's long-term overall safety profile in a broad range of adults with type 2 diabetes.
"Many guidelines recommend early use of a diabetes treatment with cardiovascular benefit," said Waheed Jamal, MD, Corporate Vice President and Head of Cardiovascular Metabolic Medicine, Boehringer Ingelheim. "When other therapies such as DPP-4 inhibitors are considered for people with type 2 diabetes, physicians need a treatment with an established long-term safety profile. With these results, CAROLINA expands our understanding of the long-term cardiovascular safety of linagliptin, which now has one of the most comprehensive datasets on the cardiovascular safety of a DPP-4 inhibitor."
"These data provide further confidence in the well-established safety and tolerability profile of linagliptin for the treatment of adults with type 2 diabetes," added Jeff Emmick, MD, PhD, Vice President, Product Development, Lilly Diabetes. "Linagliptin is an important option for physicians considering a DPP-4 inhibitor for their patients with type 2 diabetes. Boehringer Ingelheim and Lilly look forward to sharing the full results later this year."
The full results of CAROLINA will be presented on 10 June at the American Diabetes Association's 79th Scientific Sessions in San Francisco, United States.
CAROLINA (CARdiovascular Outcome study of LINAgliptin versus glimepiride in patients with type 2 diabetes) is a multi-national, randomised, double-blind, active-controlled clinical trial that involved 6,033 adults with type 2 diabetes from 43 countries at more than 600 sites observed for a median duration of more than 6 years.1,2 The trial included adults with early type 2 diabetes: adults with a median disease duration of 6.2 years, who either received no treatment at all, or received 1-2 glucose lowering agents (e.g. metformin).2 It was designed to assess the effect of Trajenta (linagliptin) (5 mg once daily) compared to the sulphonylurea glimepiride (both added to stable background glucose-lowering medication and cardiovascular standard of care) on cardiovascular safety in adults with type 2 diabetes and increased cardiovascular risk or established cardiovascular disease.1,2 These people reflect patients that doctors typically see in their daily clinical practice.6
CAROLINA was led by an academic trial steering committee and Boehringer Ingelheim and Eli Lilly and Company. CAROLINA is the first DPP-4 inhibitor, active-comparator cardiovascular outcome trial.
About Trajenta (linagliptin)
Trajenta is a one dose, once daily DPP-4 inhibitor that provides significant efficacy in the reduction of blood sugar levels for adults with type 2 diabetes. It can be prescribed for adults with type 2 diabetes regardless of age, disease duration, ethnicity, body mass index (BMI), liver and kidney function.3 Trajenta has the lowest kidney excretion rate of all DPP-4 inhibitors.7,8,9,10
About our cardiovascular outcome trials
Cardiovascular outcome trials are highly relevant, as cardiovascular disease is a major complication and the leading cause of death in type 2 diabetes. Worldwide, most people with type 2 diabetes die of a cardiovascular event.4 In 2015, Boehringer Ingelheim and Eli Lilly and Company announced results from the landmark cardiovascular outcome trial EMPA-REG OUTCOMEwith the SGLT2 inhibitor empagliflozin, which reduced the relative risk of cardiovascular death by 38 percent in adults with type 2 diabetes and established cardiovascular disease, on top of standard of care.11,12,13,14,15 As a result, empagliflozin was the first oral type 2 diabetes medicine to have either a cardiovascular indication or data on the reduction of the risk of cardiovascular death included in the label in many countries.11,12
CAROLINA is one of two cardiovascular outcome trialswith the DPP-4 inhibitor, linagliptin.1,2 CAROLINA and the CArdiovascular safety and Renal Microvascular outcomE with LINAgliptin in patients with type 2 diabetes at high vascular risk trial (CARMELINA)5,16 provide one of the most comprehensive datasets on the long-term safety of a DPP-4-inhibitor.
CARMELINA is a multi-national, randomised, double-blind, placebo-controlled clinical trial that involved 6,979 adults with type 2 diabetes from 27 countries at more than 600 sites observed for a median duration of 2.2 years.5,14 CARMELINA studied the impact of Trajenta (linagliptin) on cardiovascular and kidney safety in adults with type 2 diabetes at high risk for heart and/or kidney disease.5,14 The trial met its primary endpoint,17 with linagliptin demonstrating a similar cardiovascular safety profile compared to placebo when added to standard of care.5 CARMELINAalso included a key secondary composite endpoint,18 showing a similar kidney safety profile compared to placebo.5 The overall safety profile of linagliptinin CARMELINA was consistent with previous data and no new safety signals were observed.3,5 CARMELINA also showed a similar rate of hospitalisation for heart failure for linagliptin compared to placebo.5
To learn more about CARMELINA, please visit: https://www.carmelinatrial.com/
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