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As negative control, we used acetaminophen, while furosemide was the positive control. A pooled reported odds ratio analysis in the French, Japanese, and Spanish national pharmacovigilance databases was performed. On The Spanish Pharmacovigilance System for Human Use Drugs, we conducted a bullous pemphigoid-metformin association analysis within the period 1982\u20132018. <jats:italic>Main outcome measure<\/jats:italic> Adverse reaction cases in pharmacovigilance databases and the disproportionality through the reporting odds ratio. <jats:italic>Results<\/jats:italic> Within The Spanish Pharmacovigilance System for Human Use Drugs, we found 45 cases of bullous pemphigoid in dipeptidase-4 inhibitors patients. Median age was 77\u00a0years (range 72\u201382). The median latency period was 7\u00a0months (range 0.23\u201386). The Bullous pemphigoid-dipeptidase-4 inhibitors association was established with a reporting odd ratio\u2009=\u200970.0 (95% confidence intervals 49.1\u201310.1). In the combined analysis of the three aforementioned pharmacovigilance databases, the pooled reporting odd ratio was 81.0 (95% confidence intervals 69.5\u201394.4). <jats:italic>Conclusion<\/jats:italic> The composite estimator for the three national pharmacovigilance databases yields clear evidence of a Bullous pemphigoid-dipeptidase-4 inhibitors association, which was statistically significant for both the pharmacological class as a whole and each of the dipeptidase-4 inhibitors agents under investigation. Metformin\u2019s role in the incidence of bullous pemphigoid appeared casual rather than causal. No differences between Caucasian and Asian populations were noted.<\/jats:p>","DOI":"10.1007\/s11096-020-01003-6","type":"journal-article","created":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T08:02:51Z","timestamp":1583395371000},"page":"713-720","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Bullous pemphigoid associated with the use of dipeptidil peptidase-4 inhibitors: analysis from studies based on pharmacovigilance databases"],"prefix":"10.1007","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1946-0408","authenticated-orcid":false,"given":"Juan A.","family":"Molina-Guarneros","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Sainz-Gil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosario","family":"Sanz-Fadrique","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Rodr\u00edguez-Jim\u00e9nez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ester","family":"Navarro-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luis H.","family":"Martin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,3,5]]},"reference":[{"key":"1003_CR1","unstructured":"Cima, Agencia Espa\u00f1ola de Medicamentos y Productos Sanitarios, Health Care professionals. https:\/\/cima.aemps.es\/cima\/pdfs\/ft\/07383002\/FT_07383002.pdf. 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The information comes from a variety of sources, and the probability that the suspected adverse effect is drug-related is not the same in all cases. The discussion and conclusions of this study are the\u00a0authors\u2019 responsability and do not represent the opinion of the SEFVH or the AEMPS.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}