Dipeptidyl peptidase-4 inhibitor-induced autoimmune diseases: Current evidence

Table 4 Clinical characteristics of case-control studies reporting dipeptidyl peptidase-4 inhibitor-induced bullous pemphigoid

Ref.	Type of the study	Population	Effect of gender	Latency period	Age	Outcome
Plaquevent et al[50], 2019	Multicentre case-control study	Out of 1787 patients with BP, 108 subjects were gliptin users. Comparison with a large general population data base	NA	14.8 mo (interquartile range 6.0-26.7 mo)	77.9 ± 9.3 yr	No difference in outcome between gliptin withdrawal vs continued groups
Schaffer et al[51], 2017	Retrospective case-control study	Patients with diabetes and BP (n = 23) compared with patients with only diabetes (n = 170)	NA	Range: 5-48 mo	77.6 yr	Favourable outcome after gliptin withdrawal; however topical and systemic therapy were required in most of the cases
Béné et al[59], 2016	Case/non case analysis from database	Patients with BP (n = 150) compared with other spontaneous adverse drug reactions	NA	10 mo (range 8 d-37 mo)	74 yr (range 45-91)	Favourable outcome in patients when DPP-4is were discontinued. Median time to improvement was 10 d ( interquartile range : 5-15 d)
Benzaquen et al[68], 2018	Retrospective case-control study with 1:2 design	Patients with diabetes and BP (n = 61) compared with patients with only diabetes (n = 122)	Male aOR 4.36 (95%CI: 1.38-13.83), females 1.64 (95%CI: 0.53-5.11)	Median 8.2 mo (range 10 d to 3 yr)	79.1 ± 7.0 yr	Favourable outcome when DPP-4is were discontinued
Kridin and Bergman[71], 2018	Retrospective case-control study	Diabetes patients with BP (n = 82) vs age and gender matched control population with only diabetes (n = 328)	Male OR 4.46 (95%CI: 2.11-9.40), female OR 1.88 (95%CI: 0.92-3.86)	Median 10.4 mo (range 1.0-26.5 mo)	79.1 ± 9.1 yr	Favourable outcome in gliptin withdrawal group

aOR: Adjusted odds ratio; BP: Bullous pemphigoid; CI: Confidence interval; DPP-4is: Dipeptidyl peptidase-4 inhibitors; NA: Not available; OR: Odds ratio.