Evaluation of Risk of Bullous Pemphigoid With Initiation of Dipeptidyl Peptidase–4 Inhibitor vs Second-generation Sulfonylurea

This cohort study (using data from two insurance claims databases) found the incidence rate of bullous pemphigoid per 1000 person-years was higher in initiators of DPP-4 inhibitors than in initiators of second-generation sulfonylureas (0.42 v 0.31; HR 1.42; 95% CI 1.17-1.72).

SPS commentary:

Subgroup analyses by age, sex, race, and individual DPP-4 agents were performed, and the results of these suggested higher rates in DPP-4 inhibitor initiators vs sulfonylurea initiators in those who were 65 years or older (HR 1.62; 95% CI 1.32-1.99), white (1.70; 1.30-2.24) and treated with linagliptin (1.68; 1.16-2.43). The authors caution clinicians to be aware of this rare adverse effect, particularly in these subgroups.


JAMA Dermatology