Dipeptidyl peptidase IV inhibitors, a risk factor for bullous pemphigoid: Retrospective multicenter case-control study from France and Switzerland - 12/05/18
, Luca Borradori, MD b, Philippe Berbis, MD a, Simone Cazzaniga, MS b, c, René Valero, MD, PhD d, Marie-Aleth Richard, MD e, Laurence Feldmeyer, MD, PhD bAbstract |
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.
Le texte complet de cet article est disponible en PDF.Key words : bullous pemphigoid, case-control study, diabetes, dipeptidyl peptidase-4 inhibitor, gliptin, risk factor
Abbreviations used : BP, CI, DPP4i, OR, SD
Plan
| Funding sources: None. |
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| Conflicts of interest: None disclosed. |
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| Reprints not available from the authors. |
Vol 78 - N° 6
P. 1090-1096 - juin 2018 Retour au numéro
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