{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T14:25:17Z","timestamp":1781360717441,"version":"3.54.1"},"reference-count":54,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T00:00:00Z","timestamp":1678406400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Diabetes Invest"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Aims\/Introduction<\/jats:title><jats:p>Although the association between dipeptidyl peptidase\u20104 (DPP\u20104) inhibitors and bullous pemphigoid (BP) has begun to be established, some studies have suggested there are risk differences among DPP\u20104 inhibitors. We conducted a population\u2010based cohort study to examine the risk differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Using the claims databases of the Fukuoka Prefecture Wide\u2010Area Association of Latter\u2010Stage Elderly Healthcare between April 1, 2013 and March 31, 2017, we conducted a retrospective cohort study to compare patients receiving one DPP\u20104 inhibitor with those who were prescribed another antidiabetic drug. The primary outcome was an adjusted hazard ratio (HR) of the development of bullous pemphigoid during a 3\u2010year follow\u2010up. The secondary outcome was the development of BP requiring systemic steroids immediately after the diagnosis. These were estimated using Cox proportional hazards regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study comprised 33,241 patients, of which 0.26% (<jats:italic>n<\/jats:italic>\u00a0=\u00a088) developed bullous pemphigoid during follow\u2010up. The percentages of patients with bullous pemphigoid who required immediate systemic steroid treatment was 0.11% (<jats:italic>n<\/jats:italic>\u00a0=\u00a037). We analyzed four DPP\u20104 inhibitors: sitagliptin, vildagliptin, alogliptin, and linagliptin. Vildagliptin and linagliptin raised the risk of BP significantly (primary outcome, vildagliptin, HR 2.411 [95% confidence interval (CI) 1.325\u20134.387], linagliptin, HR 2.550 [95% CI 1.266\u20135.136], secondary outcome, vildagliptin HR 3.616 [95% CI 1.495\u20138.745], linagliptin HR 3.556 [95% CI 1.262\u201310.024]). A statistically significant risk elevation was not observed with sitagliptin and alogliptin (primary outcome, sitagliptin, HR 0.911 [95% CI 0.508\u20131.635], alogliptin, HR 1.600 [95% CI 0.714\u20133.584], secondary outcome, sitagliptin, HR 1.192 [95% CI 0.475\u20132.992], alogliptin, HR 2.007 [95% CI 0.571\u20137.053]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Not all the DPP\u20104 inhibitors could induce bullous pemphigoid significantly. Therefore, the association warrants further investigations before generalization.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jdi.14004","type":"journal-article","created":{"date-parts":[[2023,3,10]],"date-time":"2023-03-10T16:07:14Z","timestamp":1678464434000},"page":"756-766","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Risk heterogeneity of bullous pemphigoid among dipeptidyl peptidase\u20104 inhibitors: A population\u2010based cohort study using Japanese <scp>Latter\u2010Stage<\/scp> Elderly Healthcare Database"],"prefix":"10.1111","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0503-2266","authenticated-orcid":false,"given":"Yumi","family":"Harano","sequence":"first","affiliation":[{"name":"Department of Health Care Administration and Management, Graduate School of Medical Sciences Kyushu University  Fukuoka City Fukuoka Japan"},{"name":"Department of General Internal Medicine Local Incorporated Administrative Agency Saga\u2010Ken Medical Centre Koseikan  Saga Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutaka","family":"Mitamura","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Graduate School of Medical Sciences Kyushu University  Fukuoka City Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Health Care Administration and Management, Graduate School of Medical Sciences Kyushu University  Fukuoka City Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takako","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Health Care Administration and Management, Graduate School of Medical Sciences Kyushu University  Fukuoka City Fukuoka Japan"},{"name":"Department of Health Sciences, Faculty of Medical Sciences Kyushu University  Fukuoka City Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Babazono","sequence":"additional","affiliation":[{"name":"Department of Health Care Administration and Management, Graduate School of Medical Sciences Kyushu University  Fukuoka City Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,10]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"IDF diabetes atlas, 8th edn","author":"International Diabetes Federation","year":"2017"},{"key":"e_1_2_7_3_1","unstructured":"Ministry of Health Labour and Welfare.The National Health and Nutrition Survey in Japan 2016.2017. 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