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Dipeptidyl‐peptidase IV inhibitors ( DPP4i )‐associated bullous pemphigoid: Estimating the clinical profile and exploring intraclass differences
Author(s) -
Kridin Khalaf
Publication year - 2020
Publication title -
dermatologic therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 68
eISSN - 1529-8019
pISSN - 1396-0296
DOI - 10.1111/dth.13790
Subject(s) - medicine , linagliptin , vildagliptin , bullous pemphigoid , gastroenterology , eosinophilia , dipeptidyl peptidase , dipeptidyl peptidase 4 , dipeptidyl peptidase 4 inhibitor , prednisone , endocrinology , diabetes mellitus , immunology , type 2 diabetes mellitus , biochemistry , chemistry , enzyme , type 2 diabetes , antibody
Abstract Data regarding the clinical characteristics of patients with dipeptidyl‐peptidase IV inhibitors (DPP4i)‐associated BP is inconclusive. We aimed to characterize the clinical features of patients with DPP4i‐associated BP, and to assess whether there are phenotypic differences associated with different agents belonging to the DPP4i class. A retrospective prevalence study was performed, including all consecutive patients diagnosed with BP throughout the years 2000 to 2019. The study included 397 patients with BP, of whom 58 (14.6%) were DPP4i‐associated. Compared to other patients with BP, patients with DPP4i‐associated BP had a more prominent male preponderance (60.3% vs 41.0%; P = .006), presented more frequently with extensive disease (60.3% vs 46.3%; P = .049), had greater truncal (96.6% vs 85.5%; P = .019) and cephalic (51.7% vs 33.6%; P = .008) involvement, and had less frequent peripheral eosinophilia (25.9% vs 51.9%; P < .001). Compared to patients with vildagliptin‐associated BP, those with linagliptin‐associated BP were managed by higher dosage of systemic corticosteroids in order to achieve disease control (prednisone > 1 mg/kg: 68.2% vs 40.0%; P = .046). In conclusion, DPP4i‐associated BP seems to have a unique clinical profile characterized by male predominance, extensive disease, truncal and cephalic involvement, and less peripheral eosinophilia. Linagliptin may be associated with a harder course necessitating more aggressive therapy.