{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:19:39Z","timestamp":1784819979984,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2019,6,19]],"date-time":"2019-06-19T00:00:00Z","timestamp":1560902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust J Dermatology"],"published-print":{"date-parts":[[2020,2]]},"abstract":"Abstract<\/jats:title>Background\/Objective<\/jats:title>There have been a number of case reports and small clinical series reporting the potential association between dipeptidyl peptidase\u20104 inhibitors (DPPI<\/jats:styled-content>s) for diabetes and the onset of bullous pemphigoid (BP<\/jats:styled-content>). The aim of this study was to assess the association between DPPI<\/jats:styled-content> use and BP<\/jats:styled-content>, and whether this varied according to DPPI<\/jats:styled-content> type.<\/jats:p><\/jats:sec>Methods<\/jats:title>We performed a systematic review and meta\u2010analysis according to PRISMA<\/jats:styled-content> guidelines. We identified five studies with cases and controls. We performed unadjusted and adjusted meta\u2010analyses to assess the potential association.<\/jats:p><\/jats:sec>Results<\/jats:title>Adjusted meta\u2010analysis revealed significant association between DPPI<\/jats:styled-content> use and BP<\/jats:styled-content> (OR<\/jats:styled-content> 2.13, 95% CI<\/jats:styled-content> 1.59\u20132.86, I<\/jats:italic>2<\/jats:sup>\u00a0=\u00a046%, P<\/jats:italic>\u00a0<\u00a00.00001). This association was stronger between vildagliptin and BP<\/jats:styled-content> (OR<\/jats:styled-content> 5.08, 95% CI<\/jats:styled-content> 1.70\u201315.19, P<\/jats:italic>\u00a0=\u00a00.004) compared to linagliptin (OR<\/jats:styled-content> 2.87, 95%CI<\/jats:styled-content> 1.06\u20137.79, P<\/jats:italic>\u00a0=\u00a00.04), and no association was found between sitagliptin and BP<\/jats:styled-content> (OR<\/jats:styled-content> 1.29, 95%CI<\/jats:styled-content> 0.79\u20132.08, P<\/jats:italic>\u00a0=\u00a00.31). Subgroup analysis demonstrated that the association between DPPI<\/jats:styled-content> use and BP<\/jats:styled-content> remained significant in males (OR<\/jats:styled-content> 2.35, 95% CI<\/jats:styled-content> 1.46\u20133.78, P<\/jats:italic>\u00a0=\u00a00.0005) and females (OR<\/jats:styled-content> 1.88, 95%CI<\/jats:styled-content> 1.10\u20133.22, P<\/jats:italic>\u00a0=\u00a00.02).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Limitations were that studies reviewed were retrospective by design which are susceptible to bias and lack of randomisation. Our adjusted analysis supports a significant association between DPPI<\/jats:styled-content> use and onset of bullous pemphigoid. Vildagliptin had the highest odds of BP<\/jats:styled-content>. These findings have clinical implications for dermatologists and the management of patients with diabetes and being treated with DPPI<\/jats:styled-content> agents.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajd.13100","type":"journal-article","created":{"date-parts":[[2019,6,19]],"date-time":"2019-06-19T10:03:31Z","timestamp":1560938611000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Dipeptidyl peptidase\u20104 inhibitors and bullous pemphigoid: A systematic review and adjusted meta\u2010analysis"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5940-3555","authenticated-orcid":false,"given":"Kevin","family":"Phan","sequence":"first","affiliation":[{"name":"Department of Dermatology Liverpool Hospital Sydney New South Wales Australia"},{"name":"Faculty of Medicine University of New South Wales Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8684-1462","authenticated-orcid":false,"given":"Olivia","family":"Charlton","sequence":"additional","affiliation":[{"name":"Department of Dermatology Royal North Shore Hospital Sydney New South Wales Australia"},{"name":"Northern Clinical School Sydney Medical School University of Sydney Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0995-4372","authenticated-orcid":false,"given":"Saxon D","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Dermatology Royal North Shore Hospital Sydney New South Wales Australia"},{"name":"Northern Clinical School Sydney Medical School University of Sydney Sydney New South Wales Australia"},{"name":"The Dermatology and Skin Cancer Centre Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,6,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12616580"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12016-007-0030-y"},{"key":"e_1_2_6_4_1","first-page":"562","article-title":"Furosemide\u2010induced bullous pemphigoid: case report and review of literature","volume":"5","author":"Lee JJ","year":"2006","journal-title":"J. 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