SAN FRANCISCO — Researchers identified certain factors that were linked to a higher associated risk of developing bullous pemphigoid (BP), including dementia and the use of spironolactone, according to study results presented at the American Diabetes Association 79th Scientific Sessions, held June 7 to 11, 2019, in San Francisco, California.
Investigators sought to determine risk factors associated with the development of BP and examine the relationship between BP and the use of dipeptidyl peptidase-4 inhibitor (DPP-4i) therapy in patients with type 2 diabetes (T2D).
Researchers included 14,178 patients with T2D receiving DDP-4is and 28,374 matched controls from the National Health Insurance Research Database from 2009 to 2013. To be included in the DPP-4i cohort, patients were required to have been receiving DPP-4i therapy for ≥84 days, while the control arm consisted of patients with T2D who had never used DPP-4is. Patients were matched based on gender and age within 5 years at a ratio of 1:2.
There were 17 BP events reported in the control participants and 15 in participants receiving DPP-4is. The incidence of BP was higher in the DPP-4i group compared with the control group (1.41 vs 0.59/1000 person-years; adjusted hazard ratio [aHR], 2.14; 95% CI, 1.02-4.50). The associated risk for BP was lower in patients receiving metformin (aHR, 0.38; 95% CI, 0.18-0.79) and higher in patients receiving spironolactone (aHR, 3.06; 95% CI, 1.25-7.51). Patients with a diagnosis of dementia also had a higher associated risk of developing BP (aHR, 3.55; 95% CI, 1.30-9.66). Overall, the cumulative incidence of BP was higher in the DPP-4i group vs the control cohort (log-rank test, P =.01).
Researchers concluded that, “[DPP-4is] were associated with an increased risk of the development of BP in patients with [T2D].” In addition, patients who used metformin had a lower risk for developing BP compared with patients who did not use metformin.
Guo J, Chen HH, Yang Y, Chen C. The risk factors of bullous pemphigoid and associated risk between bullous pemphigoid and dipeptidyl peptidase-iv inhibitors in patients with type 2 diabetes mellitus: a retrospective cohort study. Presented at: American Diabetes Association 79th Scientific Sessions; June 7-11, 2019; San Francisco, CA. Poster 1160-P.