Dipeptidyl-peptidase IV inhibitor (DPP4i) confers increased odds of bullous pemphigoid even years after drug initiation

• DOI: 10.1007/s00403-021-02317-9
• Publication Date: 2022-01-15T07:02:40Z
• Authors: Khalaf Kridin; Orly Avni; Giovanni Damiani; Dana Tzur Bitan; Erez Onn; Orly Weinstein; Arnon D. Cohen
• Keywords: Dipeptidyl peptidase-4 inhibitor; Dipeptidyl peptidase; Protease inhibitor (pharmacology); Drug repositioning

The timing pattern in which dipeptidyl-peptidase IV inhibitors (DPP4i) confer the risk of bullous pemphigoid (BP) is unknown. To investigate odds BP following exposure to DPP4i and perform a duration-response analysis evaluating relation duration culprit drug. A population-based nested case-control study was performed comparing diabetic patients with (n = 1458) age-, sex- ethnicity-matched control subjects 6051) respect prevalence DPP4i. Adjusted ratios (ORs) were estimated by logistic regression. Overall associated an 80% increase subsequent (OR, 1.81; 95% CI, 1.46-2.08; P < 0.001). In intraclass analysis, increased association vildagliptin 3.40; 2.69-4.29; 0.001) sitagliptin 1.56; 1.33-1.84; highest likelihood found 1-2 years after commencing drug 2.66; 1.97-3.59; across all time periods retained its statistical significance even ≥ 6 initiation 1.44; 1.09-1.91; 0.011). Relative other BP, DPP4i-associated more likely be admitted inpatient dermatologic wards 1.66; 1.30-2.13; had higher mean(SD) numbers outpatient dermatologist visits (14.7[14.8] vs. 12.3[13.2], respectively; 0.006). should suspected as predisposing factor for numerous initiation.