Gliptin-Associated Bullous Pemphigoid - A Series of 3 Cases.

Indian Dermatol Online J

Department of Dermatology, College of Medicine and Sagore Dutta Medical College, Kamarhati, West Bengal, India.

Published: October 2024

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616943PMC
http://dx.doi.org/10.4103/idoj.idoj_699_23DOI Listing

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Article Synopsis
  • Bullous pemphigoid (BP) is a rare autoimmune skin disorder, becoming more frequent with associations noted with certain diabetes medications called gliptins.
  • A study analyzed 30 idiopathic bullous pemphigoid (IBP) patients and 86 gliptin-associated BP (GABP) patients to explore genetic risk factors.
  • The research found a significant link between the HLA-DQB1*03:01 allele and both IBP and GABP, suggesting genetic markers that could indicate susceptibility to BP, particularly in individuals who have taken gliptins.
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Article Synopsis
  • Drug-associated bullous pemphigoid can occur in patients with type 2 diabetes who use gliptins (dipeptidyl-peptidase 4 inhibitors) long-term, prompting a study to identify risk factors.
  • The research compared 76 patients who developed bullous pemphigoid after gliptin treatment to 8,060 who did not, and found a significant association with Alzheimer’s disease, dementia, and the concurrent use of thiazide or loop diuretics.
  • It concluded that gliptins should be used carefully in diabetic patients with dementia and those on diuretics, recommending sitagliptin over linagliptin and vildagliptin to reduce risk.
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The use of dipeptidyl peptidase 4 (DPP4) inhibitors, (also known as gliptins), is associated with an increased risk of bullous pemphigoid (BP), an autoimmune blistering skin disease. To explore the mechanism behind gliptin-associated BP we investigated circulating autoantibodies against the major BP autoantigen BP180 in serum samples from patients with type 2 diabetes (T2D) with preceding gliptin medication (n = 136) or without (n = 136). Sitagliptin was the most frequently prescribed gliptin (125/136 patients).

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