Association between dipeptidyl peptidase-4 inhibitors and risk of bullous pemphigoid in patients with type 2 diabetes: A population-based cohort study

Association between sodium‐glucose co‐transporter 2 inhibitors and risk of bullous pemphigoid in patients with type 2 diabetes: a nationwide population‐based cohort study

“…In our study, we also found that age, renal disease, cerebrovascular disease, epilepsy, DPP4i users and insulin users were associated with an increased risk of BP in the multivariate analysis, which were consistent with previous studies. 6,8,22,32 BP mainly occurred in the elderly population, which might be related to associated comorbidities, medication usage and remodelling, and dysregulation of the immune system. 32 Renal diseases also posed an increased risk for BP in the multivariate analysis, which is less discussed in the literature.…”

“…Some proposed that the exposure of neural isoforms of BP180 and BP230 in neurological diseases may induce cross‐reactive autoantibodies against cutaneous antigens and lead to subsequent BP 36 . DPP4i, a common anti‐diabetic agent, has been linked to BP in recent years, with growing evidence supporting this association 6,8,15 . Dipeptidyl peptidase 4 (DPP4) is a cell surface receptor that takes part in the conversion of plasminogen into plasmin, which could cleave BP180 at the NC16A domain 37 .…”

“…Growing evidence has suggested that dipeptidyl peptidase 4 inhibitors (DPP4i) posed the highest risk among all anti‐diabetic agents. In our previous nationwide population‐based cohort study, we found that DPP4i had a 2.2‐fold increase in the risk of BP 8 . In another meta‐analysis, considerable association between DPP4i usage and BP was observed 9,10 ; however, this was not significant with other anti‐diabetic agents, such as metformin, sulfonylureas, thiazolidinediones and glucagon‐like peptide 1 analogs 6 …”

“…In our previous nationwide population-based cohort study, we found that DPP4i had a 2.2-fold increase in the risk of BP. 8 In another meta-analysis, considerable association between DPP4i usage and BP was observed 9,10 ; however, this was not significant with other anti-diabetic agents, such as metformin, sulfonylureas, thiazolidinediones and glucagon-like peptide 1 analogs. 6 Sodium-glucose co-transporter 2 inhibitor (SGLT2i), a novel class of anti-diabetic agents, inhibits the reabsorption of glucose in the proximal renal tubule and thus increases the excretion of urinary glucose.…”

The association between statins and subsequent risk of bullous pemphigoid: A population-based cohort study

“…The diagnostic accuracy of this BP identification algorithm has been validated in a previous study. 5 All enrolled subjects were followed-up from the index date until the first BP diagnosis, death, or December 31, 2013.…”