Dipeptidyl peptidase–4 (DPP-4) inhibitors and second-gen sulfonylureas are both used in the treatment of type-2 diabetes. Recent evidence suggests that patients initiating treatment with DPP-4 inhibitors or second-gen sulfonylureas may be at a higher risk of bullous pemphigoid, a skin condition that causes large, fluid-filled blisters. This study aims to evaluate the risk of bullous pemphigoid associated with the use of DPP-4 inhibitors and second-gen sulfonylureas.
This cohort study included a total of 1,664,880 patients with type-2 diabetes who had initiated DPP-4 inhibitors or sulfonylurea. The participants were matched using 1:1 propensity score matching, and the incidence rates of bullous pemphigoid were measures in terms of hazard ratios (HR). The primary outcome of the study was incident bullous pemphigoid.
The incident rate of bullous pemphigoid was 0.42 per 1,000 person-years in the DPP-4 inhibitor group, as compared with 0.31 per 1,000 person-years in the sulfonylurea group. Among patients who were 65 years of age or older, higher rates per 1,000 person-years (0.79 for DPP-4 inhibitors and 0.49 for sulfonylurea) were observed.
The research concluded that patients who initiated DPP-inhibitor treatment for type-2 diabetes were at higher risk of developing bullous pemphigoid compared with those who initiated sulfonylurea treatment.