記述言語：英語   出版者・発行元：Journal of Diabetes Investigation  

Aims/Introduction: Although the association between dipeptidyl peptidase-4 (DPP-4) inhibitors and bullous pemphigoid (BP) has begun to be established, some studies have suggested there are risk differences among DPP-4 inhibitors. We conducted a population-based cohort study to examine the risk differences. Materials and Methods: Using the claims databases of the Fukuoka Prefecture Wide-Area Association of Latter-Stage Elderly Healthcare between April 1, 2013 and March 31, 2017, we conducted a retrospective cohort study to compare patients receiving one DPP-4 inhibitor with those who were prescribed another antidiabetic drug. The primary outcome was an adjusted hazard ratio (HR) of the development of bullous pemphigoid during a 3-year follow-up. The secondary outcome was the development of BP requiring systemic steroids immediately after the diagnosis. These were estimated using Cox proportional hazards regression models. Results: The study comprised 33,241 patients, of which 0.26% (n = 88) developed bullous pemphigoid during follow-up. The percentages of patients with bullous pemphigoid who required immediate systemic steroid treatment was 0.11% (n = 37). We analyzed four DPP-4 inhibitors: sitagliptin, vildagliptin, alogliptin, and linagliptin. Vildagliptin and linagliptin raised the risk of BP significantly (primary outcome, vildagliptin, HR 2.411 [95% confidence interval (CI) 1.325–4.387], linagliptin, HR 2.550 [95% CI 1.266–5.136], secondary outcome, vildagliptin HR 3.616 [95% CI 1.495–8.745], linagliptin HR 3.556 [95% CI 1.262–10.024]). A statistically significant risk elevation was not observed with sitagliptin and alogliptin (primary outcome, sitagliptin, HR 0.911 [95% CI 0.508–1.635], alogliptin, HR 1.600 [95% CI 0.714–3.584], secondary outcome, sitagliptin, HR 1.192 [95% CI 0.475–2.992], alogliptin, HR 2.007 [95% CI 0.571–7.053]). Conclusions: Not all the DPP-4 inhibitors could induce bullous pemphigoid significantly. Therefore, the association warrants further investigations before generalization.

DOI： 10.1111/jdi.14004

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PubMed

記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

ジペプチジルペプチダーゼ4(DPP-4)阻害薬毎の水疱性類天疱瘡(BP)発症のリスク差を検討した。2013年4月1日～2017年3月31日における福岡県後期高齢者医療広域連合の請求データベースを用いて後向きコホート研究を行った。主要評価項目は3年間の観察期間中におけるBP発症の補正後ハザード比、副次評価項目は全身ステロイド投与を要するBP発症とした。33241例におけるBPの発症率は0.26%(88例)で、全身ステロイドの即時投与を要した患者は0.11%(37例)であった。Sitagliptin、vildagliptin、alogliptin、linagliptinについて解析し、vildagliptinとlinagliptinでのBP発症リスクが有意に高く、sitagliptinとalogliptinでは有意なリスク増加はみられなかった。

記述言語：英語   出版者・発行元：Oxford University Press