Department of Diabetes and Endocrinology, Nara Medical University, Kashihara, Japan.
Department of Public health, Health Management and Policy, Nara Medical University, Kashihara, Japan.
J Diabetes Investig. 2022 Mar;13(3):460-467. doi: 10.1111/jdi.13676. Epub 2021 Oct 11.
AIMS/INTRODUCTION: We assessed the association between dipeptidyl peptidase-4 inhibitors (DPP-4is) and bullous pemphigoid (BP) and time-dependent changes in the risk for developing BP after DPP-4i initiation.
The present population-based, real-world study was carried out using the Japanese National Database dataset collected between 2013 and 2018. To assess independent correlations between DPP-4is and the development of BP, the self-controlled case series method was used.
Among the cohort followed up for a median of 1,540 days, 53,027 patients were likely to develop BP. The possible incidence rate of BP in all 150,328,339 patients was 10.4/100,000 person-years. Among the 9,705,814 patients with type 2 diabetes, 15,634 were likely to develop BP. The possible incidence rate of BP in patients with type 2 diabetes was 38.1/100,000 person-years, whereas that in patients with type 2 diabetes who did and did not use DPP-4is was 40.7 and 30.0/100,000 person-years, respectively. Analysis of the 28,705 patients with type 2 diabetes likely to develop BP after initial DPP-4i use showed a risk ratio of 2.15 (95% confidence interval [CI] 1.75-2.63), 1.70 (95% CI 1.37-2.11), 1.44 (95% CI 1.15-1.82), 1.25 (95% CI 0.98-1.59), 0.84 (95% CI 0.63-1.10), 0.84 (95% CI 0.64-1.11) and 1.05 (95% CI 0.92-1.20), for the risk period of ≤30, 31-60, 61-90, 91-120, 121-150, 151-180 and 181-365 days, respectively.
Although DPP-4is were associated with increased risk for BP, the risk was particularly significant within 3 months from first use.
目的/引言：我们评估了二肽基肽酶-4 抑制剂（DPP-4i）与大疱性类天疱疮（BP）之间的关联，以及 DPP-4i 起始后发生 BP 的风险随时间的变化。
本基于人群的真实世界研究使用了 2013 年至 2018 年期间收集的日本国家数据库数据集。为了评估 DPP-4i 与 BP 发展之间的独立相关性，使用了自我对照病例系列法。
在随访中位数为 1540 天的队列中，有 53027 名患者可能发展为 BP。所有 150328339 名患者的 BP 可能发生率为 10.4/100000 人年。在 9705814 名 2 型糖尿病患者中，有 15634 名可能发展为 BP。2 型糖尿病患者的 BP 可能发生率为 38.1/100000 人年，而使用和未使用 DPP-4i 的 2 型糖尿病患者的发生率分别为 40.7 和 30.0/100000 人年。对 28705 名初始使用 DPP-4i 后可能发展为 BP 的 2 型糖尿病患者进行分析，结果显示风险比为 2.15（95%置信区间[CI]1.75-2.63）、1.70（95%CI1.37-2.11）、1.44（95%CI1.15-1.82）、1.25（95%CI0.98-1.59）、0.84（95%CI0.63-1.10）、0.84（95%CI0.64-1.11）和 1.05（95%CI0.92-1.20），风险期分别为≤30、31-60、61-90、91-120、121-150、151-180 和 181-365 天。
虽然 DPP-4i 与 BP 风险增加相关，但风险在首次使用后 3 个月内尤其显著。
