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Publications

Journal Article Ahead of print 2 citations

PubMed: 42622752 DOI: 10.1007/s11739-026-04499-4

Oral semaglutide vs DPP-4 inhibitors in reducing risk of cognitive impairment in elderly patients with HFpEF and obesity.

Intern Emerg Med

Authors: Giuseppe Armentaro, Cristiana Vitale, Velia Cassano, Marilisa Panza, Ilaria Gareri, Maria Mirabelli, Elena Succurro, Francesco Andreozzi, Antonio Brunetti, Gianluigi Savarese, Maurizio Volterrani, Giorgio Sesti, Giuseppe Massimo Claudio Rosano, Angela Sciacqua

Affiliations

  • Geriatrics Division, "Renato Dulbecco" University Hospital of Catanzaro, 88100, Catanzaro, Italy.
  • Department of Human Sciences and Promotion of Quality of Life, San Raffaele Open, University of Rome, Rome, Italy.
  • IRCCS San Raffaele, Rome, Italy.
  • Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100, Catanzaro, Italy.
  • Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, 88100, Catanzaro, Italy.
  • Department of Health Sciences, University "Magna Græcia" of Catanzaro, 88100, Catanzaro, Italy.
  • Research Center for the Prevention and Treatment of Metabolic Diseases (CR‑METDIS), University Magna Græcia, 88100, Catanzaro, Italy.
  • Division of Cardiology, Department of Medicine, Karolinska Institutet, and Heart and Vascular and Neuro Theme, Karolinska University Hospital, Stockholm, Sweden.
  • Department of Clinical and Molecular Medicine, University of Rome-Sapienza, 00185, Rome, Italy.

Abstract

Heart failure with preserved ejection fraction (HFpEF), obesity, type 2 diabetes mellitus are common in elderly patients and are associated with an increased risk of cognitive impairment (CoI). In these patients, the protective metabolic and vascular effects of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are well established. The aim of this study was to evaluate effects of one-year treatment with oral semaglutide versus DPP-4 inhibitors (DPP4i), as an add-on to the hypoglycaemic therapy, on the incidence of CoI in patients with HFpEF, obesity, and type 2 diabetes. 246 elderly outpatients were recruited and divided into two groups (oral semaglutide vs. DPP4i), accurately matched for age, sex, and body mass index (BMI). At one-year follow-up, 106 new cases of CoI were observed in the entire study population (43.1 events/100 patients/year). A significant difference was found between the two groups: 33 cases with oral semaglutide (26.8 events/100 patients/year) versus 73 cases with DPP4i (59.3 events/100 patients/year), p<0.0001. Logistic regression analysis indicated a 77% reduced risk of incident CoI with oral semaglutide compared to DPP4i. In elderly patients with HFpEF, obesity and type 2 diabetes, oral semaglutide seems to have a positive effect in reducing the incidence of cognitive impairment.

MeSH

Diabetes Mellitus, Glucagon-Like Peptide 1, Incidence, Internal Medicine, Heart Failure, Diastolic, Cognitive Dysfunction, Dipeptidyl-Peptidase Iv Inhibitors, Aged, Cognition Disorders, Obesity, Therapeutics, Diabetes Mellitus, Type 2, Semaglutide