DPP-4 Inhibitors Linked to Inflammatory Bowel Disease

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Higher risk of inflammatory bowel disease with longer use of dipeptidyl peptidase-4 inhibitor
Higher risk of inflammatory bowel disease with longer use of dipeptidyl peptidase-4 inhibitor

(HealthDay News) -- Dipeptidyl peptidase-4 (DPP-4) inhibitors are associated with increased risk of inflammatory bowel disease among patients with type 2 diabetes, according to a study published online in The BMJ.

Devin Abrahami, from the Jewish General Hospital in Montreal, and colleagues conducted a population-based cohort study to examine whether use of DPP-4 inhibitors is associated with the incidence of inflammatory bowel disease in patients with type 2 diabetes. Participants included 141,170 patients starting antidiabetic drugs between Jan. 1, 2007, and Dec. 31, 2016, with follow-up until June 30, 2017.

The researchers identified 208 incident inflammatory bowel disease events during 552,413 person-years of follow-up (crude incidence rate, 37.7 per 100,000 person-years; 95% confidence interval, 32.7 to 43.1). Use of DPP-4 inhibitors correlated with elevated risk of inflammatory bowel disease (53.4 versus 34.5 per 100,000 person-years; hazard ratio, 1.75; 95% confidence interval, 1.22 to 2.49). With longer duration of use there was an increase in hazard ratios, reaching a peak after three to four years of use (hazard ratio, 2.90; 95% confidence interval, 1.31 to 6.41) and decreasing after more than four years of use (hazard ratio, 1.45; 95% confidence interval, 0.44 to 4.76). There was a similar pattern with time since initiation of DPP-4 inhibitors. In several sensitivity analyses, these findings remained consistent.

"In this first population-based study, the use of DPP-4 inhibitors was associated with an increased risk of inflammatory bowel disease," the authors write. "Although these findings need to be replicated, physicians should be aware of this possible association."

Reference

Abrahami D, Douros A, Yin H, et al. Dipeptidyl peptidase-4 inhibitors and incidence of inflammatory bowel disease among patients with type 2 diabetes: population based cohort study. BMJ 2018;360 doi: 10.1136/bmj.k872

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