大疱性类天疱疮与二肽基肽酶 4 抑制剂的相关性：一项十年前瞻性观察研究。
The association of bullous pemphigoid with dipeptidyl-peptidase 4 inhibitors: a ten-year prospective observational study.
机构信息
Second Department of Internal Medicine Research Unit and Diabetes Center, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Rimini 1 Chaidari, Athens, Greece.
Second Department of Dermatology and Venereology, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
出版信息
BMC Endocr Disord. 2021 Feb 11;21(1):23. doi: 10.1186/s12902-021-00689-7.
BACKGROUND
Bullous pemphigoid is the most common bullous chronic autoimmune skin disease. Recent studies have suggested dipeptidyl-peptidase 4 inhibitors as possible predisposing agents of bullous pemphigoid. The objective of our study was to prospectively estimate the association between gliptins and the development of bullous pemphigoid.
METHODS
We conducted a prospective study which included all patients diagnosed with biopsy-proven bullous pemphigoid in the Dermatology Department of our hospital between April 1, 2009 and December 31,2019. The diagnosis of bullous pemphigoid was based on specific clinical, histological and immunological features.
RESULTS
Overall 113 consecutive patients (age 75 ± 13 years, 62 females) with the diagnosis of bullous pemphigoid were enrolled. Seventy-six patients (67.3%) suffered from type 2 Diabetes and 52 (46%) were treated with dipeptidyl-peptidase 4 inhibitors. The most frequent prescribed gliptin was vildagliptin, being administered to 45 cases (39.8% of total patients enrolled, 86.5% of the patients treated with gliptins). Gliptins were withdrawn immediately after the diagnosis of bullous pemphigoid, which together with steroid administration led to remission of the rash.
CONCLUSIONS
This study revealed that treatment with dipeptidyl-peptidase 4 inhibitors, especially vildagliptin, is significantly associated with an increased risk of bullous pemphigoid development.
背景
大疱性类天疱疮是最常见的慢性自身免疫性大疱性皮肤病。最近的研究表明二肽基肽酶 4 抑制剂可能是大疱性类天疱疮的诱发因素。我们的研究目的是前瞻性评估二肽基肽酶 4 抑制剂与大疱性类天疱疮发展之间的关联。
方法
我们进行了一项前瞻性研究，纳入了 2009 年 4 月 1 日至 2019 年 12 月 31 日期间在我院皮肤科经活检确诊为大疱性类天疱疮的所有患者。大疱性类天疱疮的诊断基于特定的临床、组织学和免疫学特征。
结果
共纳入 113 例连续患者（年龄 75±13 岁，62 例女性），诊断为大疱性类天疱疮。76 例（67.3%）患有 2 型糖尿病，52 例（46%）接受二肽基肽酶 4 抑制剂治疗。最常开的二肽基肽酶 4 抑制剂是维格列汀，共开给 45 例（总患者的 39.8%，接受二肽基肽酶 4 抑制剂治疗患者的 86.5%）。大疱性类天疱疮诊断后立即停用二肽基肽酶 4 抑制剂，同时给予皮质类固醇治疗，皮疹消退。
结论
本研究表明，二肽基肽酶 4 抑制剂治疗，尤其是维格列汀，与大疱性类天疱疮发展的风险增加显著相关。
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