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Updated with TRIUMPH-1 and TRANSCEND-T2D-1 Phase 3 data presented at the ADA 86th Scientific Sessions (June 2026)

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However, DPP-4 inhibitors have not reduced the risk of major adverse cardiovascular events, possibly because potentiation of SDF-1 enhances plaque growth and instability, activates deleterious neurohormonal mechanisms, and promotes cardiac inflammation and fibrosis

Increasing use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) raises concern for interactions with warfarin