scholarly journals Dipeptidyl peptidase 4 inhibitors and bullous pemphigoid − more evidence of a link: a report of three cases

2020 ◽  
Vol 20 (2) ◽  
pp. 147-148
Author(s):  
Amrita Randhawa ◽  
Donna Torley ◽  
Alastair Kerr ◽  
Grant Wylie

Recently, dipeptidyl peptidase 4 (DPP-4) inhibitors, an antidiabetic medication, have been implicated in the development of bullous pemphigoid, the most common autoimmune cutaneous blistering disorder. In this report we present three cases of DPP-4 associated bullous pemphigoid in our dermatology department. These cases illustrate the importance for clinicians to consider a drug as a trigger for bullous pemphigoid in elderly patients with diabetes.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Vaia Lambadiari ◽  
Aikaterini Kountouri ◽  
Foteini Kousathana ◽  
Emmanouil Korakas ◽  
Georgios Kokkalis ◽  
...  

Abstract Background Bullous pemphigoid is the most common bullous chronic autoimmune skin disease. Recent studies have suggested dipeptidyl-peptidase 4 inhibitors as possible predisposing agents of bullous pemphigoid. The objective of our study was to prospectively estimate the association between gliptins and the development of bullous pemphigoid. Methods We conducted a prospective study which included all patients diagnosed with biopsy-proven bullous pemphigoid in the Dermatology Department of our hospital between April 1, 2009 and December 31,2019. The diagnosis of bullous pemphigoid was based on specific clinical, histological and immunological features. Results Overall 113 consecutive patients (age 75 ± 13 years, 62 females) with the diagnosis of bullous pemphigoid were enrolled. Seventy-six patients (67.3%) suffered from type 2 Diabetes and 52 (46%) were treated with dipeptidyl-peptidase 4 inhibitors. The most frequent prescribed gliptin was vildagliptin, being administered to 45 cases (39.8% of total patients enrolled, 86.5% of the patients treated with gliptins). Gliptins were withdrawn immediately after the diagnosis of bullous pemphigoid, which together with steroid administration led to remission of the rash. Conclusions This study revealed that treatment with dipeptidyl-peptidase 4 inhibitors, especially vildagliptin, is significantly associated with an increased risk of bullous pemphigoid development.


Author(s):  
Hsin-Hung Chen ◽  
Shang-Yi Li ◽  
Weishan Chen ◽  
Chia-Hung Kao

In this retrospective study, we attempted to evaluate the association between dipeptidyl peptidase-4 (DPP-4) inhibitors and allergic rhinitis in patients with diabetes. We analyzed the Longitudinal Health Insurance Database 2000 subdatabase. Our study population included patients with type 2 diabetes (ICD-9-CM 250) between 2009 and 2012, and the study groups were DPP-4 inhibitor users and nonusers. Propensity scores were estimated in a multivariable logistic regression model for the analysis of allergic rhinitis (ICD-9-CM 477.9). Each group consisted of 6204 patients. DPP-4 inhibitor users had a reduced risk of allergic rhinitis (aHR = 0.74, 95% confidence interval (CI) = 0.61–0.90) in all stratifications. Among women, DPP-4 inhibitor users had a lower risk of allergic rhinitis (aHR = 0.67, 95% CI = 0.50–0.90). Among patients aged older than 40 years, DPP-4 inhibitor users had a decreased risk of allergic rhinitis (those aged 40–59: aHR = 0.75, 95% CI = 0.56–0.99; those aged ≧60: aHR = 0.73, 95% CI = 0.54–0.97). Among patients with comorbidities, the risk of allergic rhinitis for DPP-4 inhibitor users was 0.73 (95% CI = 0.60–0.90). High-dose (cumulative defined daily dose ≧648mg) DPP-4 inhibitor users had a decreased risk of allergic rhinitis (aHR = 0.23, 95% CI = 0.15–0.35). Our study revealed that Asian patients with diabetes who used DPP-4 inhibitors had decreased risk of allergic rhinitis, especially for DPP-4 inhibitor treatment in patients who were women, were older than 40 years, had higher diabetes severity scores, were taking higher doses of DPP-4 inhibitors, and had diabetes with comorbidities.


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