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Clinical Phenotypes and the Clinical Course of Bullous Pemphigoid Receiving Dipeptidyl Pepitidase-4 Inhibitor Treatment: An Analysis of Cases in a Single Japanese Center

OBJECTIVE: Several studies have shown an increased risk of bullous pemphigoid (BP) when receiving dipeptidyl pepitidase-4 inhibitor (DPP-4i) treatment. The present study explored the associations of DPP-4i treatment with the clinical phenotypes and clinical course of BP. METHODS: We analyzed data of...

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Autores principales: Nakagawa, Yosuke, Toyoda, Masao, Saito, Nobumichi, Kaneyama, Noriko, Shimizu, Tomomichi, Mabuchi, Tomotaka, Fukagawa, Masafumi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332970/
https://www.ncbi.nlm.nih.gov/pubmed/36328578
http://dx.doi.org/10.2169/internalmedicine.0815-22
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author Nakagawa, Yosuke
Toyoda, Masao
Saito, Nobumichi
Kaneyama, Noriko
Shimizu, Tomomichi
Mabuchi, Tomotaka
Fukagawa, Masafumi
author_facet Nakagawa, Yosuke
Toyoda, Masao
Saito, Nobumichi
Kaneyama, Noriko
Shimizu, Tomomichi
Mabuchi, Tomotaka
Fukagawa, Masafumi
author_sort Nakagawa, Yosuke
collection PubMed
description OBJECTIVE: Several studies have shown an increased risk of bullous pemphigoid (BP) when receiving dipeptidyl pepitidase-4 inhibitor (DPP-4i) treatment. The present study explored the associations of DPP-4i treatment with the clinical phenotypes and clinical course of BP. METHODS: We analyzed data of 146 patients with BP at Tokai University School of Medicine from December 1, 2009, to December 31, 2021. We obtained data by a retrospective medical record review and compared the bullous pemphigoid disease area index (BPDAI) between diabetes patients receiving DPP-4i treatment and those not receiving DPP-4i treatment. We employed multivariable linear regression models to explore the association between the DPP-4i treatment and the BPDAI scores. RESULTS: Among 53 BP patients with diabetes, 33 had developed BP during treatment with DPP-4i agents, among which vildagliptin was the most frequently used. The urticaria/erythema scores of the BPDAI were significantly lower in patients who developed BP while receiving DPP-4i treatment than among others. Of note, 69.2% of the patients who stopped DPP-4i treatment experienced complete remission, and the clinical course was more favorable in patients with lower scores for urticaria/erythema than among others. CONCLUSION: These findings suggest that, in patients who developed BP while receiving DPP-4i treatment, a noninflammatory phenotype may indicate a high likelihood that DPP-4i treatment contributes to the development of BP. The discontinuation of DPP-4i should be carefully considered in close consultation with dermatologists.
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spelling pubmed-103329702023-07-12 Clinical Phenotypes and the Clinical Course of Bullous Pemphigoid Receiving Dipeptidyl Pepitidase-4 Inhibitor Treatment: An Analysis of Cases in a Single Japanese Center Nakagawa, Yosuke Toyoda, Masao Saito, Nobumichi Kaneyama, Noriko Shimizu, Tomomichi Mabuchi, Tomotaka Fukagawa, Masafumi Intern Med Original Article OBJECTIVE: Several studies have shown an increased risk of bullous pemphigoid (BP) when receiving dipeptidyl pepitidase-4 inhibitor (DPP-4i) treatment. The present study explored the associations of DPP-4i treatment with the clinical phenotypes and clinical course of BP. METHODS: We analyzed data of 146 patients with BP at Tokai University School of Medicine from December 1, 2009, to December 31, 2021. We obtained data by a retrospective medical record review and compared the bullous pemphigoid disease area index (BPDAI) between diabetes patients receiving DPP-4i treatment and those not receiving DPP-4i treatment. We employed multivariable linear regression models to explore the association between the DPP-4i treatment and the BPDAI scores. RESULTS: Among 53 BP patients with diabetes, 33 had developed BP during treatment with DPP-4i agents, among which vildagliptin was the most frequently used. The urticaria/erythema scores of the BPDAI were significantly lower in patients who developed BP while receiving DPP-4i treatment than among others. Of note, 69.2% of the patients who stopped DPP-4i treatment experienced complete remission, and the clinical course was more favorable in patients with lower scores for urticaria/erythema than among others. CONCLUSION: These findings suggest that, in patients who developed BP while receiving DPP-4i treatment, a noninflammatory phenotype may indicate a high likelihood that DPP-4i treatment contributes to the development of BP. The discontinuation of DPP-4i should be carefully considered in close consultation with dermatologists. The Japanese Society of Internal Medicine 2022-11-02 2023-06-15 /pmc/articles/PMC10332970/ /pubmed/36328578 http://dx.doi.org/10.2169/internalmedicine.0815-22 Text en Copyright © 2023 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
Nakagawa, Yosuke
Toyoda, Masao
Saito, Nobumichi
Kaneyama, Noriko
Shimizu, Tomomichi
Mabuchi, Tomotaka
Fukagawa, Masafumi
Clinical Phenotypes and the Clinical Course of Bullous Pemphigoid Receiving Dipeptidyl Pepitidase-4 Inhibitor Treatment: An Analysis of Cases in a Single Japanese Center
title Clinical Phenotypes and the Clinical Course of Bullous Pemphigoid Receiving Dipeptidyl Pepitidase-4 Inhibitor Treatment: An Analysis of Cases in a Single Japanese Center
title_full Clinical Phenotypes and the Clinical Course of Bullous Pemphigoid Receiving Dipeptidyl Pepitidase-4 Inhibitor Treatment: An Analysis of Cases in a Single Japanese Center
title_fullStr Clinical Phenotypes and the Clinical Course of Bullous Pemphigoid Receiving Dipeptidyl Pepitidase-4 Inhibitor Treatment: An Analysis of Cases in a Single Japanese Center
title_full_unstemmed Clinical Phenotypes and the Clinical Course of Bullous Pemphigoid Receiving Dipeptidyl Pepitidase-4 Inhibitor Treatment: An Analysis of Cases in a Single Japanese Center
title_short Clinical Phenotypes and the Clinical Course of Bullous Pemphigoid Receiving Dipeptidyl Pepitidase-4 Inhibitor Treatment: An Analysis of Cases in a Single Japanese Center
title_sort clinical phenotypes and the clinical course of bullous pemphigoid receiving dipeptidyl pepitidase-4 inhibitor treatment: an analysis of cases in a single japanese center
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332970/
https://www.ncbi.nlm.nih.gov/pubmed/36328578
http://dx.doi.org/10.2169/internalmedicine.0815-22
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