{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T23:51:37Z","timestamp":1792281097741,"version":"4.4.0"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100010425","name":"tri-service general hospital","doi-asserted-by":"publisher","award":["TSGH-PH-E113011"],"award-info":[{"award-number":["TSGH-PH-E113011"]}],"id":[{"id":"10.13039\/501100010425","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020950","name":"National Science and Technology Council","doi-asserted-by":"publisher","award":["NSTC 113-2314-B-016-049-MY2"],"award-info":[{"award-number":["NSTC 113-2314-B-016-049-MY2"]}],"id":[{"id":"10.13039\/501100020950","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therapeutic Advances in Musculoskeletal"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Osteoarthritis (OA) is the most prevalent form of arthritis. Currently, no disease-modifying OA drugs are available. Increasing interest has focused on repurposing antidiabetic medications to prevent OA. Preclinical studies showed that dipeptidyl-peptidase 4 inhibitors (DPP-4is) may protect against cartilage degeneration via anti-inflammatory and anti-senescent mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate whether DPP-4i use is associated with a decreased risk of incident OA and joint replacement in patients with type 2 diabetes mellitus (T2DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A nationwide, population-based, matched new-user, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Using Taiwan\u2019s National Health Insurance Research Database (2008\u20132018), adult patients with newly diagnosed T2DM prescribed with DPP-4is were matched 1:1 to non-users based on age, sex, index year, and Diabetes Complications and Severity Index score. The primary endpoint was incident OA, while the secondary endpoints were total hip replacement (THR) and total knee replacement (TKR) attributed to OA. Cox proportional hazards models were used to estimate the adjusted hazard ratio (aHR) for comorbidities and concurrent medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In a sample of 1,282,796 patients with newly diagnosed T2DM, 165,333 pairs were matched for treatment with or without DPP-4is. Among 165,333 matched pairs (mean age: 58.6\u2009years; 56.2% male), DPP-4i use was associated with lower risks of OA (aHR: 0.42; 95% confidence interval (CI): 0.41\u20130.44), THR (aHR: 0.38; 95% CI: 0.30\u20130.48), and TKR (aHR: 0.42; 95% CI: 0.37\u20130.46), with benefits increasing with dosage. Moreover, DPP-4i use was associated with a significantly lower cumulative incidence of OA, THR, and TKR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In this first nationwide cohort study, DPP-4is were associated with decreased OA incidence and fewer joint replacement surgeries among patients with T2DM. These findings indicate the joint-protective effects of DPP-4is, highlighting their relevance to drug repurposing and clinical decision-making in patients at high risk of OA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1759720x261434279","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T01:35:08Z","timestamp":1774834508000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Dipeptidyl peptidase-4 inhibitors are associated with a lower risk of osteoarthritis in patients with type 2 diabetes"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8960-1758","authenticated-orcid":false,"given":"Yu-Hsiu","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Tri-Service General Hospital, Taipei, Taiwan"},{"name":"Division of Rheumatology, Immunology and Allergy, Department of Medicine, School of Medicine, College of Medicine, National Defense Medical University, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Byers Kraus","sequence":"additional","affiliation":[{"name":"Department of Medicine, Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2622-7524","authenticated-orcid":false,"given":"Yu-Sheng","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"},{"name":"Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzu-Min","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan"},{"name":"Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsiang-Yen","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ching-Kuei","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, 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