Dipeptidyl peptidase IV inhibitors, a risk factor for bullous pemphigoid: Retrospective multicenter case-control study from France and Switzerland

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:78

Article

Borradori, Luca¹  Cazzaniga, Simone^1,2  Valero, Rene³  Richard, Marie-Aleth^4,5  Feldmeyer, Laurence¹ 

[1] Aix Marseille Univ, Hop Nord, Assistance Publ Hop Marseille, Dept Dermatol, Chemin Bourrely, F-13015 Marseille, France

[2] Univ Bern, Bern Univ Hosp, Inselspital, Dept Dermatol, Bern, Switzerland

[3] Ctr Studi GISED, Bergamo, Italy

[4] Aix Marseille Univ, Assistance Publ Hop Marseille, Hop de la Conception,INRA,1260,INSERM,1062, Dept Nutr Metab Dis Endocrinol,NORT, Marseille, France

[5] Aix Marseille Univ, Hop La Timone, Assistance Publ Hop Marseille,INSERM,UMR 911,CRO2, Ctr Rech Oncol Biol & Oncopharmacol,Dept Dermatol, Marseille, France

关键词: bullous pemphigoid;    case-control study;    diabetes;    dipeptidyl peptidase-4 inhibitor;    gliptin;    risk factor;   

DOI  :  10.1016/j.jaad.2017.12.038

来源: Elsevier

【 摘 要 】

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.

【 授权许可】

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