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They also found that treatment with exenatide resulted in a marked increase in anti-inflammatory cytokines (IL-4 and IL-10) alongside a reduction in pro-inflammatory cytokines (TNF and IL-1) [65]

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Market performance has also benefited from growing physician acceptance, favorable clinical evidence, and improved patient adherence due to enhanced delivery systems

The DPP-4 inhibitor CV safety outcome trials have unequivocally demonstrated that DPP-4 inhibition is not associated with any increased risk of major adverse CV events (MACE), with the four trials so far published (124127) having hazard ratios (HR) for the primary outcome of between 0.96 and 1.02 (Table 2)