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.

中文翻译：

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二肽基肽酶IV抑制剂，大疱性类天疱疮的危险因素：法国和瑞士的回顾性多中心病例对照研究

背景

病例报告表明，二肽基肽酶4抑制剂（DPP4is）与大疱性类天疱疮（BP）的发展有关。

客观的

评估DPP4i治疗与BP发生之间的关联。

方法

我们进行了一项回顾性1：2病例对照研究，比较了2014年1月1日从瑞士（伯尔尼）和法国（马赛）皮肤科获得的糖尿病和BP糖尿病患者与年龄和性别匹配的糖尿病对照患者。 2016年7月31日。

结果

我们收集了61例糖尿病和血压患者以及122例对照。DPP4is与BP的患病风险增加相关（调整后的优势比，2.64; 95％置信区间，1.19-5.85; P  = .02），维格列汀显示出最高的调整后优势比（3.57 [95％置信区间，1.07] -11.84; P  = .04]）。分层分析显示，男性和80岁或80岁以上的患者之间的关联性更强。DPP4i的撤药和一线治疗的开始导致95％的病例临床缓解。

局限性

这是三级转诊医院的一项回顾性研究。我们将分析重点放在DPP4i摄入量上，而没有分析二甲双胍的潜在孤立作用。

结论

DPP4is，尤其是维格列汀，与发生BP的风险增加有关。需要仔细评估它们的使用，特别是在高风险患者中，例如男性和80岁或80岁以上的患者。