Is there an association between dipeptidyl peptidase-4 inhibitors and autoimmune disease? A population-based study
Is there an association between dipeptidyl peptidase-4 inhibitors and autoimmune disease? A population-based study
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DOI：
10.1007/s12026-018-9005-8
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发表时间：
2018-06-01
影响因子：
4.4
通讯作者：
Cohen, Arnon D.
中科院分区：
文献类型：
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作者：
Kridin, Khalaf;Amber, Kyle;Cohen, Arnon D.
二肽基肽酶 4 抑制剂 (DPP4is) 与自身免疫性疾病的关系存在争议。虽然这些药物被认为是通过阻断 T 细胞增殖和细胞因子产生来治疗多种炎症性疾病的新方法，但它们被发现会引发炎症性肠病、炎症性关节炎和大疱性类天疱疮。我们的目标是检查 DPP4i 与自身免疫性疾病之间的关联。这项研究是利用 Clalit Health Services 数据库进行的一项横断面研究。对接受 DPP4i 治疗的患者与年龄、性别和种族匹配的对照患者之间 15 种自身免疫/免疫介导疾病的患病率进行了比较。使用卡方进行单变量分析，并使用学生 t 检验进行多变量分析，并使用逻辑回归模型进行多变量分析。该研究包括 283 名接受 DPP4i 药物治疗的患者和 5660 名年龄、性别和种族匹配的糖尿病对照受试者。克罗恩病（1.1 vs. 0.3%；优势比 (OR)，3.56；95% CI，1.04-12.21，P = 0.031）、银屑病（2.5 vs. 1.2%；OR，2.12；95% CI，0.99-4.66；P = 0.050）和DPP4i 治疗患者的桥本甲状腺炎（16.6 vs. 12.6%；OR，1.38；95% CI，1.00-1.91；P = 0.049）显着高于对照组。其余自身免疫性疾病的患病率在 DPP4i 治疗的患者与其匹配的对照受试者之间没有显着差异。总之，这项基于人群的研究表明，DPP4i 摄入量与三种自身免疫性和炎症性疾病有关，这三种疾病属于不同自身免疫性疾病群的一部分，其中包括多发性硬化症、牛皮癣、甲状腺炎、大疱性类天疱疮和炎症性肠病。需要进行实验研究来确定 DPP4i 在该自身免疫簇中的作用。
The association of dipeptidyl peptidase-4 inhibitors (DPP4is) with autoimmune diseases is controversial. While these agents were proposed as a novel therapeutic approach for several inflammatory diseases by blocking T cell proliferation and cytokine production, they were found to trigger inflammatroy bowel disease, inflammatory arthritis and bullous pemphigoid. Our objective is to examine the association between DPP4i and autoimmune diseases. This study was conducted as a cross-sectional study utilizing the database of Clalit Health Services. The prevalence of 15 autoimmune-/immune-mediated diseases was compared between patients on DPP4i treatment and age-, sex-, and ethnicity-matched controls. Univariate analysis was performed using chi-square and the Student t test and multivariate analysis was performed using a logistic regression model. The study included 283 patients treated with DPP4i agents and 5660 age-, sex-, and ethnicity-matched diabetic control subjects. The prevalence of Crohn's disease (1.1 vs. 0.3%; odds ratios (OR), 3.56; 95% CI, 1.04-12.21, P = 0.031), psoriasis (2.5 vs. 1.2%; OR, 2.12; 95% CI, 0.99-4.66; P = 0.050), and Hashimoto's thyroiditis (16.6 vs. 12.6%; OR, 1.38; 95% CI, 1.00-1.91; P = 0.049) was significantly higher in patients on DPP4i treatment than in controls. The prevalence of the remaining autoimmune diseases did not differ significantly between DPP4i-treated patients and their matched control subjects. In conclusion, this population-based study demonstrates an association of DPP4i intake with three autoimmune and inflammatory diseases noted to be part of a distinct autoimmune cluster that includes multiple sclerosis, psoriasis, thyroiditis, bullous pemphigoid, and inflammatory bowel disease. Experimental studies are required to define the role of DPP4i in this autoimmune cluster.