PMID- 24919467
OWN - NLM
STAT- MEDLINE
DCOM- 20160112
LR  - 20211021
IS  - 1468-2060 (Electronic)
IS  - 0003-4967 (Print)
IS  - 0003-4967 (Linking)
VI  - 74
IP  - 11
DP  - 2015 Nov
TI  - Dipeptidyl peptidase-4 inhibitors in type 2 diabetes may reduce the risk of 
      autoimmune diseases: a population-based cohort study.
PG  - 1968-75
LID - 10.1136/annrheumdis-2014-205216 [doi]
AB  - OBJECTIVE: Dipeptidyl peptidase-4 (DPP4), also known as CD26, is a transmembrane 
      glycoprotein that has a costimulatory function in the immune response. DPP4 
      inhibitors (DPP4i) are oral glucose-lowering drugs for type 2 diabetes mellitus 
      (T2DM). This study evaluated the risk of incident rheumatoid arthritis (RA) and 
      other autoimmune diseases (AD) such as systemic lupus erythematosus, psoriasis, 
      multiple sclerosis and inflammatory bowel disease, associated with DPP4i in 
      patients with T2DM. METHODS: Using US insurance claims data (2005-2012), we 
      conducted a population-based cohort study that included initiators of combination 
      therapy with DPP4i (DPP4i plus metformin) and non-DPP4i (non-DPP4i plus 
      metformin). RA and other AD were identified with >/=2 diagnoses and >/=1 dispensing 
      for AD-specific immunomodulating drugs or steroids. Composite AD includes RA or 
      other AD. Propensity score (PS)-stratified Cox proportional hazards models 
      compared the risk of AD in DPP4i initiators versus non-DPP4i, controlling for 
      potential confounders. RESULTS: After asymmetric trimming on the PS, 73 928 
      patients with T2DM starting DPP4i combination therapy and 163 062 starting 
      non-DPP4i combination therapy were selected. Risks of incident RA and composite 
      AD were lower in the DPP4i group versus non-DPP4i with the PS-stratified HR of 
      0.66 (95% CI 0.44 to 0.99) for RA, 0.73 (0.51 to 1.03) for other AD and 0.68 (95% 
      CI 0.52 to 0.89) for composite AD. CONCLUSIONS: In this large cohort of diabetic 
      patients, those initiating DPP4i combination therapy appear to have a decreased 
      risk of incident AD including RA compared with those initiating non-DPP4i 
      combination therapy. These results may suggest possible pharmacological pathways 
      for prevention or treatment of AD.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://group.bmj.com/group/rights-licensing/permissions.
FAU - Kim, Seoyoung C
AU  - Kim SC
AD  - Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's 
      Hospital, Boston, Massachusetts, USA Division of Rheumatology, Allergy and 
      Immunology, Brigham and Women's Hospital, Boston, Massachusetts, USA Department 
      of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA.
FAU - Schneeweiss, Sebastian
AU  - Schneeweiss S
AD  - Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's 
      Hospital, Boston, Massachusetts, USA Department of Epidemiology, Harvard School 
      of Public Health, Boston, Massachusetts, USA.
FAU - Glynn, Robert J
AU  - Glynn RJ
AD  - Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's 
      Hospital, Boston, Massachusetts, USA.
FAU - Doherty, Michael
AU  - Doherty M
AD  - Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's 
      Hospital, Boston, Massachusetts, USA.
FAU - Goldfine, Allison B
AU  - Goldfine AB
AD  - Joslin Diabetes Center, Boston, Massachusetts, USA.
FAU - Solomon, Daniel H
AU  - Solomon DH
AD  - Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's 
      Hospital, Boston, Massachusetts, USA Division of Rheumatology, Allergy and 
      Immunology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
LA  - eng
GR  - P50 HL083813/HL/NHLBI NIH HHS/United States
GR  - R01 DK088214/DK/NIDDK NIH HHS/United States
GR  - K24 AR055989/AR/NIAMS NIH HHS/United States
GR  - K23 AR059677/AR/NIAMS NIH HHS/United States
GR  - R01 AR056215/AR/NIAMS NIH HHS/United States
GR  - R56 DK095451/DK/NIDDK NIH HHS/United States
GR  - P60 AR047782/AR/NIAMS NIH HHS/United States
GR  - U01 HL101422/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140611
PL  - England
TA  - Ann Rheum Dis
JT  - Annals of the rheumatic diseases
JID - 0372355
RN  - 0 (Dipeptidyl-Peptidase IV Inhibitors)
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Sulfonylurea Compounds)
RN  - 0 (Thiazolidinediones)
RN  - 9100L32L2N (Metformin)
SB  - IM
MH  - Arthritis, Rheumatoid/epidemiology
MH  - Autoimmune Diseases/*epidemiology
MH  - Cohort Studies
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Dipeptidyl-Peptidase IV Inhibitors/*therapeutic use
MH  - Female
MH  - Humans
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Inflammatory Bowel Diseases/epidemiology
MH  - Lupus Erythematosus, Systemic/epidemiology
MH  - Male
MH  - Metformin/therapeutic use
MH  - Middle Aged
MH  - Multiple Sclerosis/epidemiology
MH  - Proportional Hazards Models
MH  - Protective Factors
MH  - Psoriasis/epidemiology
MH  - Sulfonylurea Compounds/therapeutic use
MH  - Thiazolidinediones/therapeutic use
MH  - United States/epidemiology
PMC - PMC4263684
MID - NIHMS599511
OTO - NOTNLM
OT  - Autoimmune Diseases
OT  - Epidemiology
OT  - Rheumatoid Arthritis
OT  - Systemic Lupus Erythematosus
COIS- Competing interests Kim receives research support from Pfizer and tuition support 
      for the Pharmacoepidemiology Program at the Harvard School of Public Health 
      partially funded by the Pharmaceutical Research and Manufacturers of America 
      (PhRMA) foundation. Schneeweiss is consultant to WHISCON, LLC and to Aetion, Inc. 
      of which he also owns shares. He is principal investigator of 
      investigator-initiated grants to the Brigham and Women's Hospital from Novartis, 
      and Boehringer-Ingelheim unrelated to the topic of this study. Doherty has 
      nothing to disclose. Glynn received research grants from AstraZeneca and 
      Novartis. Solomon receives research support from Amgen, Lilly, Pfizer, and 
      CORRONA and serves in unpaid roles on studies sponsored by Pfizer, Novartis, 
      Lilly, and Bristol Myers Squibb. Solomon also receives royalties from UpToDate.
EDAT- 2014/06/13 06:00
MHDA- 2016/01/13 06:00
PMCR- 2016/11/01
CRDT- 2014/06/13 06:00
PHST- 2014/01/08 00:00 [received]
PHST- 2014/05/24 00:00 [accepted]
PHST- 2014/06/13 06:00 [entrez]
PHST- 2014/06/13 06:00 [pubmed]
PHST- 2016/01/13 06:00 [medline]
PHST- 2016/11/01 00:00 [pmc-release]
AID - annrheumdis-2014-205216 [pii]
AID - 10.1136/annrheumdis-2014-205216 [doi]
PST - ppublish
SO  - Ann Rheum Dis. 2015 Nov;74(11):1968-75. doi: 10.1136/annrheumdis-2014-205216. 
      Epub 2014 Jun 11.