{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:24:28Z","timestamp":1792002268080,"version":"4.4.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Dipeptidyl peptidase\u20104 inhibitors (DPP\u20104i), glucagon\u2010like peptide\u20101 receptor agonists (GLP\u20101RA), and sodium\u2010glucose cotransporter\u20102 inhibitors (SGLT2i) are widely used for type 2 diabetes, yet their comparative immunologic safety is uncertain. To address this gap, we evaluated autoimmune disease incidence among patients treated with these agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted emulated target trials using electronic health record data from 152 health care organizations in the TriNetX network (2016\u20132023). Adults with type 2 diabetes initiating DPP\u20104i, GLP\u20101RA, or SGLT2i monotherapy and no prior autoimmune disease were included. Propensity score matching balanced demographics, comorbidities, laboratory data, and medications. Cohorts comprised 118,419 matched DPP\u20104i versus GLP\u20101RA pairs, 102,810 DPP\u20104i versus SGLT2i pairs, and 105,869 GLP\u20101RA versus SGLT2i pairs. Primary outcomes included three\u2010year risks of incident autoimmune diseases such as psoriasis, rheumatoid arthritis, systemic sclerosis, dermatomyositis, and multiple sclerosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with GLP\u20101RA, DPP\u20104i was associated with lower risk of psoriasis (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.70\u20130.85), psoriatic arthritis (HR 0.65, 95% CI 0.53\u20130.79), and autoimmune thyroiditis (HR 0.68, 95% CI 0.59\u20130.76), but higher risk of dermatomyositis (HR 2.18, 95% CI 1.24\u20133.53) and bullous pemphigoid (HR 1.78, 95% CI 1.24\u20132.46).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared with GLP\u20101RA, DPP\u20104i use decreased psoriasis and thyroiditis risk but increased dermatomyositis, bullous pemphigoid, and giant cell arteritis risk. No significant differences were observed between GLP\u20101RA and SGLT2i treatments. These findings provide novel safety signals and may inform antidiabetic drug selection while guiding future mechanistic and prospective research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr2.90046","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T05:02:01Z","timestamp":1783486921000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Autoimmune Disease Risk With\n                    <scp>GLP<\/scp>\n                    \u2010\n                    <scp>1RA<\/scp>\n                    ,\n                    <scp>DPP<\/scp>\n                    \u20104i, and\n                    <scp>SGLT2i<\/scp>\n                    Treatment in Patients With Diabetes"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7340-4954","authenticated-orcid":false,"given":"Arjun","family":"Mahajan","sequence":"first","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts"},{"name":"Division of Rheumatology, Inflammation, and Immunity Brigham and Women's Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Bates","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts"},{"name":"Department of Medicine Brigham and Women's Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Doria","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts"},{"name":"Joslin Diabetes Center  Boston Massachusetts"},{"name":"Department of Epidemiology Harvard T.H. Chan School of Public Health  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinah","family":"Foer","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts"},{"name":"Department of Medicine Brigham and Women's Hospital  Boston Massachusetts"},{"name":"Division of Allergy and Clinical Immunology Brigham and Women's Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avery H.","family":"LaChance","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts"},{"name":"Department of Dermatology Brigham and Women's Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5556-4618","authenticated-orcid":false,"given":"Jeffrey A.","family":"Sparks","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts"},{"name":"Division of Rheumatology, Inflammation, and Immunity Brigham and Women's Hospital  Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.18219"},{"key":"e_1_2_6_3_1","unstructured":"MonteroA SparksG PresiadoM et al.KFF health tracking poll May 2024: the public's use and views of GLP\u20101 drugs. 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