Association between dipeptidyl peptidase-4 inhibitors and risk of bullous pemphigoid in patients with type 2 diabetes: A population-based cohort study. (January 2021)

• Record Type: Journal Article
• Authors: Wu, Chen-Yi; Wu, Chun-Ying; Li, Chung-Pin; Chou, Yiing-Jenq; Lin, Yi-Hsian; Chang, Yun-Ting
• Is Part Of: Diabetes research and clinical practice. Volume 171(2021)
• Publication Date: 2021-01
• Subjects: Dipeptidyl peptidase 4 inhibitor -- Bullous pemphigoid -- Cohort study -- Risk factor; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2020.108546
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Dipeptidyl peptidase 4 inhibitor has been reported to be associated with increased risk of bullous pemphigoid. This cohort study confirms the use of dipeptidyl peptidase 4 inhibitor had a 2.2-fold increase in the risk of BP. The risk was the highest in those with concomitant use of dipeptidyl peptidase 4 inhibitor and insulin. The use of dipeptidyl peptidase 4 inhibitor must be monitored carefully in bullous pemphigoid patients. Abstract: Aims: Higher bullous pemphigoid (BP) risk has been reported to be associated with dipeptidyl peptidase 4 inhibitor (DPP4i). The aim of this study is to examine the association between BP risk and DPP4i treatment. Methods: We conducted a nationwide cohort study based on the Taiwan National Health Insurance Database between 2000 and 2015. 124, 619 diabetic patients who were receiving DPP4i therapy were matched 1: 1 with diabetic patients who had never received DPP4i by age, sex, duration of diabetes, insulin usage, and propensity score-matching of comorbidities. Results: The 6-year cumulative incidence of BP in the DPP4i-treated cohort was significantly higher than that in the non-DPP4i group (0.74 per 1000 vs 0.38 per 1000, P = 0.001). Modified Cox regression analysis revealed that DPP4i treatment (HR: 2.15, 95% CI: 1.18–3.91, P = 0.01), age (HR: 1.06, P < 0.001), renal disease (HR: 2.32, P < 0.001), and metformin user (HR: 1.93, P = 0.006) were associated with increased BP risk. Conclusions: DPP4i users had a 2.2-fold increase in the risk of BP, and the risk was the highest in those with concomitant use of DPP4i and insulin.