Open AccessDPP-4 inhibitor (sitagliptin)-induced seronegative rheumatoid arthritis
Author(s) -
Simonette Padron,
Everett Rogers,
Michelle Demory Beckler,
Marc M Kesselman
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-228981
Subject(s) - medicine , sitagliptin , rheumatoid arthritis , hydroxychloroquine , rheumatology , rheumatism , arthritis , sitagliptin phosphate , inflammatory arthritis , dermatology , immunology , metformin , disease , insulin , covid-19 , infectious disease (medical specialty)
Sitagliptin is a dipeptidyl peptidase-4 inhibitor commonly used in the treatment of type 2 diabetes mellitus for glycaemic control. Concerns have arisen regarding adverse events caused by this drug, particularly concerning arthralgias. Here, we report on a 56-year-old man being treated with sitagliptin who developed inflammatory arthritis after taking the drug for 6 months. The patient presented with pain, swelling and erythema in multiple joints and was eventually diagnosed with seronegative rheumatoid arthritis (RA) under the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria. His symptoms continued for several months after stopping sitagliptin and eventually went into remission after a tapered course of steroids, hydroxychloroquine and methotrexate. Furthermore, the patient is HLA-DRB3 positive, a genetic marker that is still being investigated for its role in the pathogenesis of RA and that may have been a predisposing factor in the development of this patient's inflammatory arthropathy.