Background: There were several case reports on the association between dipeptidyl peptidase-4 inhibitors (DPP-4is) and bullous pemphigoid (BP). The aim of this meta-analysis was to evaluate the risk of BP and other skin-related adverse effects (AEs) in patients with type 2 diabetes receiving DPP-4i treatment in randomized controlled trials (RCTs).
Methods: In this meta-analysis, we searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from inception to November 10, 2018. The study included RCTs assessing the effects of DPP-4is treatment compared with placebo in type 2 diabetic patients with reports of skin-related events. The odds ratio (OR) was calculated by Peto's methods.
Results: 46 randomized placebo-controlled trials with reports of skin-related events were included (n = 59,332) in this meta-analysis. Compared with placebo, the risk of BP significantly increased in DPP-4i treatment (OR = 7.39, 95% CI 2.59-21.07, I2=0%, P = 0.0002) (Figure 1), and the overall risk of skin-related AEs also increased in DPP-4i treatment (OR = 1.31, 95% CI 1.08-1.59, I2=38%, P = 0.006) (Figure 2).
Conclusions: This meta-analysis suggested that DPP-4i treatment was associated with a significant increase in the risks of BP and skin-related AEs.
W. Yang: None. X. Cai: None. S. Zhang: None. X. Han: None. L. Ji: Advisory Panel; Self; AstraZeneca. Consultant; Self; AstraZeneca, Bayer AG, Boehringer Ingelheim International GmbH, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck KGaA, Merck Sharp & Dohme Corp., Novartis AG, Novo Nordisk A/S, Roche Pharma, Sanofi, Takeda Pharmaceutical Company Limited. Research Support; Self; AstraZeneca, Bristol-Myers Squibb Company, Eli Lilly and Company, Merck Sharp & Dohme Corp., Novartis AG, Roche Pharma, Sanofi.
