Dipeptidyl peptidase IV inhibitors, a risk factor for bullous pemphigoid: Retrospective multicenter case-control study from France and Switzerland.
- Benzaquen M Department of Dermatology, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille University, Marseille, France. Electronic address: michael.benzaquen@ap-hm.fr.
- Borradori L Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- Berbis P Department of Dermatology, Hôpital Nord, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille University, Marseille, France.
- Cazzaniga S Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland; Centro Studi GISED, Bergamo, Italy.
- Valero R Department of Nutrition, Metabolic Diseases, Endocrinology, Hôpital de la Conception, Assistance Publique-Hôpitaux de Marseille, Aix-Marseille University, INSERM 1062, INRA 1260, NORT, Marseille, France.
- Richard MA Department of Dermatology, Hôpital La Timone, Assistance Publique-Hôpitaux de Marseille, UMR 911, INSERM CRO2, Centre de recherche en oncologie biologique et oncopharmacologie, Aix-Marseille University, member of the French Bullous Group from the French Society of Dermatology, Marseille, France.
- Feldmeyer L Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
- 2017-12-24
Published in:
- Journal of the American Academy of Dermatology. - 2018
bullous pemphigoid
case-control study
diabetes
dipeptidyl peptidase-4 inhibitor
gliptin
risk factor
Adrenal Cortex Hormones
Adult
Age Distribution
Aged
Case-Control Studies
Diabetes Mellitus, Type 2
Dipeptidyl-Peptidase IV Inhibitors
Female
France
Humans
Incidence
Logistic Models
Male
Middle Aged
Multivariate Analysis
Pemphigoid, Bullous
Prognosis
Retrospective Studies
Risk Assessment
Sex Distribution
Switzerland
Tertiary Care Centers
English
BACKGROUND
Case reports have suggested an association between dipeptidyl peptidase-4 inhibitors (DPP4is) and development of bullous pemphigoid (BP).
OBJECTIVE
To evaluate the association between DPP4i treatment and development of BP.
METHODS
We conducted a retrospective 1:2 case-control study, comparing case patients with diabetes and BP with age- and sex-matched control patients with diabetes issued from Swiss (Bern) and French (Marseille) dermatologic departments from January 1, 2014, to July 31, 2016.
RESULTS
We collected 61 case patients with diabetes and BP and 122 controls. DPP4is were associated with an increased risk for development of BP (adjusted odds ratio, 2.64; 95% confidence interval, 1.19-5.85; P = .02), with vildagliptin showing the highest adjusted odds ratio (3.57 [95% confidence interval, 1.07-11.84; P = .04]). Stratified analysis showed a stronger association in males and patients age 80 years or older. DPP4i withdrawal and the initiation of first-line treatments led to clinical remission in 95% of cases.
LIMITATIONS
This was a retrospective study in tertiary referral hospitals. We focused the analysis on DPP4i intake, without analyzing the potential isolated effect of metformin.
CONCLUSIONS
DPP4is, especially vildagliptin, are associated with an increased risk for development of BP. Their use needs to be carefully evaluated, particularly in high-risk patients, such as males and those age 80 years or older.
Case reports have suggested an association between dipeptidyl peptidase-4 inhibitors (DPP4is) and development of bullous pemphigoid (BP).
OBJECTIVE
To evaluate the association between DPP4i treatment and development of BP.
METHODS
We conducted a retrospective 1:2 case-control study, comparing case patients with diabetes and BP with age- and sex-matched control patients with diabetes issued from Swiss (Bern) and French (Marseille) dermatologic departments from January 1, 2014, to July 31, 2016.
RESULTS
We collected 61 case patients with diabetes and BP and 122 controls. DPP4is were associated with an increased risk for development of BP (adjusted odds ratio, 2.64; 95% confidence interval, 1.19-5.85; P = .02), with vildagliptin showing the highest adjusted odds ratio (3.57 [95% confidence interval, 1.07-11.84; P = .04]). Stratified analysis showed a stronger association in males and patients age 80 years or older. DPP4i withdrawal and the initiation of first-line treatments led to clinical remission in 95% of cases.
LIMITATIONS
This was a retrospective study in tertiary referral hospitals. We focused the analysis on DPP4i intake, without analyzing the potential isolated effect of metformin.
CONCLUSIONS
DPP4is, especially vildagliptin, are associated with an increased risk for development of BP. Their use needs to be carefully evaluated, particularly in high-risk patients, such as males and those age 80 years or older.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1016/j.jaad.2017.12.038
- PMID 29274348
- Persistent URL
- https://sonar.ch/global/documents/173467
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