Open AccessDipeptidyl peptidase‐4 inhibitors‐associated bullous pemphigoid: A retrospective study of 168 pemphigoid and 9,304 diabetes mellitus patients
Author(s) -
Kawaguchi Yohei,
Shimauchi Risa,
Nishibori Nobuhiro,
Kawashima Kiyohito,
Oshitani So,
Fujiya Atsushi,
Shibata Taiga,
Ohashi Norimi,
Izumi Kentaro,
Nishie Wataru,
Shimizu Hiroshi,
Arima Hiroshi,
Sobajima Hiroshi
Publication year - 2019
Publication title -
journal of diabetes investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.089
H-Index - 50
eISSN - 2040-1124
pISSN - 2040-1116
DOI - 10.1111/jdi.12877
Subject(s) - medicine , bullous pemphigoid , diabetes mellitus , pemphigoid , dipeptidyl peptidase 4 inhibitor , linagliptin , dipeptidyl peptidase 4 , gastroenterology , type 2 diabetes mellitus , antibody , type 2 diabetes , endocrinology , immunology
Aims/Introduction Bullous pemphigoid ( BP ) might be drug‐induced. The present study evaluated the relationship between BP and dipeptidyl peptidase‐4 inhibitors ( DPP 4Is). Materials and Methods We recruited patients diagnosed with BP at Ogaki Municipal Hospital from 1 December 2009 through 31 December 2017. We retrospectively collected data from medical records and divided patients into two groups based on whether they received DPP 4Is. Additionally, we determined the incidence of BP in patients who were first prescribed DPP 4Is at our hospital during the study period. Results Of 168 patients diagnosed with BP , 133 (79.1%) were positive for anti‐ BP 180 NC 16a antibody. A total of 32 (19.0%) patients had been prescribed a DPP 4I, 21 of whom (65.6%) were positive for anti‐ BP 180 NC 16a antibody; this rate was lower than that in patients not receiving a DPP 4I (82.3%; P = 0.0360). A total of 16 patients with type 2 diabetes mellitus had not been prescribed a DPP 4I; only one (6.3%) was positive for anti‐ BP 180 NC 16a antibody ( P = 0.0339). During the study period, 9,304 patients were prescribed DPP 4Is, eight of whom developed BP ; six (75.0%) had non‐inflammatory BP , and five of the six (83.3%) were negative for anti‐ BP 180 NC 16a antibody. Conclusions The positive rate of anti‐ BP 180 NC 16a antibody was lower in BP patients with DPP 4I than without DPP 4I, regardless of type 2 diabetes mellitus. The antibody titer was low in both the overall and type 2 diabetes mellitus populations. The prevalence of BP in 9,304 patients receiving DPP 4Is was 0.0859%, which is higher than that in the general population. As DPP 4Is are common diabetes treatments, we must be aware of the risk of BP .