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.

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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.

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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.