alogliptin and Pemphigoid--Bullous

Recent studies revealed the risk of bullous pemphigoid (BP) in patients with diabetes mellitus (DM) taking dipeptidyl peptidase 4 (DPP-4) inhibitors. To clarify the relationship between taking DPP-4 inhibitors and the risk of BP among patients with DM, we conducted a cohort study by using the National Health Insurance Research Database of Taiwan from 1 January 2009 to 31 December 2015. We identified 6340 patients with DM taking DPP-4 inhibitors and 25 360 DM patients who had not taken DPP-4 inhibitors during the 7-year follow-up period. Compared with the non-DPP-4 inhibitor group, patients taking DDP-4 inhibitors had a higher risk of BP (adjusted hazard ratio [aHR], 2.382; 95% confidence interval (CI), 1.163-4.883; P = 0.017]. Among the DPP-4 inhibitors available in Taiwan, vildagliptin showed the highest risk of BP (aHR, 2.849; 95% CI, 1.893-4.215; P < 0.001), followed by saxagliptin (aHR, 2.657; 95% CI, 1.770-3.934; P < 0.001). Subgroup analysis revealed that the higher risk of BP was observed in patients older than 65 years (aHR, 2.403; 95% CI, 1.590-3.627; P < 0.001). This study revealed that treatment with DPP-4 inhibitors, especially vildagliptin, was significantly associated with an increased risk of BP among DM patients.

Topics: Adamantane; Adult; Age Factors; Aged; Case-Control Studies; Databases, Factual; Diabetes Mellitus, Type 2; Dipeptides; Dipeptidyl-Peptidase IV Inhibitors; Female; Humans; Incidence; Linagliptin; Male; Middle Aged; Pemphigoid, Bullous; Piperidines; Risk Factors; Sitagliptin Phosphate; Taiwan; Uracil; Vildagliptin; Young Adult

Topics: Aged; Diabetes Mellitus, Type 2; Female; Humans; Hypoglycemic Agents; Pemphigoid, Bullous; Piperidines; Uracil

Topics: Aged; Diabetes Mellitus; Dipeptidyl-Peptidase IV Inhibitors; Female; HLA-DQ beta-Chains; Humans; Pemphigoid, Bullous; Piperidines; Uracil

Topics: Adamantane; Aged; Aged, 80 and over; Autoantibodies; Autoantigens; Collagen Type XVII; Dipeptidyl-Peptidase IV Inhibitors; Epitopes; Female; Humans; Immunoglobulin A; Immunoglobulin E; Immunoglobulin G; Linagliptin; Male; Membrane Glycoproteins; Middle Aged; Nitriles; Non-Fibrillar Collagens; Pemphigoid, Bullous; Piperidines; Pyrrolidines; Sitagliptin Phosphate; Uracil; Vildagliptin