Rosenstock J, Kahn SE, Johansen OE, et al. - In this randomized noninferiority clinical trial, researchers investigated patients with relatively early type 2 diabetes and elevated cardiovascular risk in order to compare cardiovascular outcomes between linagliptin (dipeptidyl peptidase-4 inhibitor) and glimepiride (sulfonylurea) in these individuals. This inquiry was held at 607 hospital and primary care sites in 43 countries and included 6,033 participants who were followed up for a median of 6.3 years. They randomly allocated participants to receive 5 mg of linagliptin once daily (n = 3,023) or 1 to 4 mg of glimepiride once daily (n = 3,010) in addition to usual care. The estimated rates of the composite outcome (cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke) for linagliptin vs glimepiride added to usual care were 11.8% vs 12.0%, respectively. The upper limit of the 95.47% CI of the hazard ratio was 1.14, which satisfied the noninferiority criterion of a hazard ratio of less than 1.3. Overall, findings revealed the noninferiority of linagliptin vs glimepiride use with regard to the risk of major cardiovascular events in this patient population.