PMID- 32741073 OWN - NLM STAT- MEDLINE DCOM- 20220124 LR - 20220124 IS - 1520-7560 (Electronic) IS - 1520-7552 (Linking) VI - 37 IP - 3 DP - 2021 Mar TI - Dipeptidyl peptidase-4 inhibitor treatment and the risk of bullous pemphigoid and skin-related adverse events: A systematic review and meta-analysis of randomized controlled trials. PG - e3391 LID - 10.1002/dmrr.3391 [doi] AB - AIMS: This meta-analysis aimed to evaluate the risk of developing bullous pemphigoid (BP) and other skin-related adverse events (AEs) in patients with type 2 diabetes (T2DM) undergoing dipeptidyl peptidase-4 inhibitor (DPP-4i) treatment in randomized controlled trials (RCTs). METHODS: In this meta-analysis, the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were searched for RCTs, which involve patients with T2DM reporting skin-related AEs. RCTs that comparatively evaluated the effects of DPP-4i treatment and placebo on patients with T2DM and reported skin-related AEs were included in the analysis. The odds ratio (OR) and 95% confidence interval (CI) were calculated using the Peto's methods. The GRADE approach was used to rate the quality of evidence. RESULTS: A total of 46 randomized placebo-controlled trials, including 3 trials with reports of BP (n = 38 011), that reported skin-related AEs were included (n = 59 332). Compared to the placebo group, the risk of developing BP was significantly higher in the DPP-4i treatment group (OR = 7.38, 95% CI 2.00-27.25, I(2) = 0%, P = .003; quality rating: very low). Additionally, DPP-4i treatment was associated with an increased overall risk of developing skin-related AEs (OR = 1.22, 95% CI 1.02-1.46, I(2) = 32%, P = .03; quality rating: moderate). CONCLUSIONS: This meta-analysis suggested that treatment with DPP-4is, including sitagliptin, saxagliptin, and linagliptin, was associated with an increased risk of developing BP. Additionally, the risk of developing skin-related AEs increased when all DPP-4is were combined. Skin lesion, especially BP, should be monitored in patients with diabetes undergoing DPP-4i treatment. Future studies should evaluate the susceptible population and develop strategies for early detection of skin-related AEs. CI - (c) 2020 John Wiley & Sons Ltd. FAU - Yang, Wenjia AU - Yang W AD - Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China. FAU - Cai, Xiaoling AU - Cai X AD - Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China. FAU - Zhang, Simin AU - Zhang S AD - Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China. FAU - Han, Xueyao AU - Han X AD - Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China. FAU - Ji, Linong AU - Ji L AUID- ORCID: 0000-0002-3262-2168 AD - Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing, China. LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't PT - Systematic Review DEP - 20200828 PL - England TA - Diabetes Metab Res Rev JT - Diabetes/metabolism research and reviews JID - 100883450 RN - 0 (Dipeptidyl-Peptidase IV Inhibitors) SB - IM MH - *Diabetes Mellitus, Type 2/drug therapy MH - *Dipeptidyl-Peptidase IV Inhibitors/adverse effects MH - Humans MH - *Pemphigoid, Bullous/chemically induced MH - Randomized Controlled Trials as Topic MH - Risk Assessment MH - *Skin Diseases/chemically induced OTO - NOTNLM OT - bullous pemphigoid OT - dipeptidyl peptidase-4 inhibitor OT - skin-related adverse events OT - type 2 diabetes EDAT- 2020/08/03 06:00 MHDA- 2022/01/27 06:00 CRDT- 2020/08/03 06:00 PHST- 2020/07/16 00:00 [revised] PHST- 2019/02/18 00:00 [received] PHST- 2020/07/17 00:00 [accepted] PHST- 2020/08/03 06:00 [pubmed] PHST- 2022/01/27 06:00 [medline] PHST- 2020/08/03 06:00 [entrez] AID - 10.1002/dmrr.3391 [doi] PST - ppublish SO - Diabetes Metab Res Rev. 2021 Mar;37(3):e3391. doi: 10.1002/dmrr.3391. Epub 2020 Aug 28.