{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:24:22Z","timestamp":1792002262707,"version":"4.4.0"},"reference-count":24,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Derm Venereol"],"abstract":"<jats:p>Psoriatic disease, encompassing psoriasis and -psoriatic arthritis, is a chronic inflammatory condition with bidirectional associations with type 2 diabetes mellitus. Current evidence regarding dipeptidyl peptidase-4 inhibitors\u2019 effects on psoriatic disease presents conflicting findings, with the impact on psoriatic arthritis remaining unexplored. This study aimed to investigate the association between dipeptidyl peptidase-4 inhibitors use and psoriatic disease risk in diabetic patients. A nationwide population-based cohort study was conducted using Taiwan\u2019s National Health Insurance Research Database (2009\u20132021), including 78,865 patients with type 2 diabetes mellitus: 15,773 dipeptidyl peptidase-4 inhibitors users and 63,092 matched controls. Primary outcomes were incident psoriasis and psoriatic arthritis. During a median follow-up of 7.08 years, 393 cases developed psoriatic disease: 51\u00a0cases in the dipeptidyl peptidase-4 inhibitors cohort vs 342 cases in controls. Dipeptidyl peptidase-4 inhibitors therapy was associated with significantly lower psoriatic disease risk (adjusted hazard ratio 0.583, 95% confidence interval 0.430\u20130.696). Individual dipeptidyl peptidase-4 inhibitors demonstrated varying protective effects, with alogliptin showing the strongest protection. In vitro experiments confirmed that dipeptidyl peptidase-4 inhibitors significantly attenuated inflammatory responses in human skin cells. This large-scale nationwide study demonstrates that dipeptidyl peptidase-4 inhibitors use is associated with a 41.7% lower risk in psoriatic disease in diabetic patients.<\/jats:p>","DOI":"10.2340\/actadv.v105.44343","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T13:46:30Z","timestamp":1762955190000},"page":"adv44343","source":"Crossref","is-referenced-by-count":2,"title":["Dipeptidyl Peptidase-4 Inhibitors Associated with Lower Psoriatic Disease Risk in Type 2 Diabetes: A 13-Year Nationwide Cohort Study with Mechanistic Validation"],"prefix":"10.2340","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7138-7757","authenticated-orcid":false,"given":"Chih-Tsung","family":"Hung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Hsiang","family":"Chung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5730-5679","authenticated-orcid":false,"given":"Tsu-Hsuan","family":"Weng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5175-9363","authenticated-orcid":false,"given":"Chun-Teng","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3286-0780","authenticated-orcid":false,"given":"Wu-Chien","family":"Chien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung-Lung","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1183","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"132698","doi-asserted-by":"crossref","unstructured":"Boehncke WH, Schon MP. Psoriasis. Lancet 2015; 386: 983\u2013994.","DOI":"10.1016\/S0140-6736(14)61909-7"},{"key":"132699","doi-asserted-by":"crossref","unstructured":"Iskandar IY, Teng-Chou C, Li-Chia C, Meng-Sui L, Yen-Yun Y, Ting-Chun W, et al. Incidence, prevalence, and mortality of people with psoriasis and psoriatic arthritis in Taiwan: a nationwide cohort study. Acta Derm Venereol 2022; 102: adv00807.","DOI":"10.2340\/actadv.v102.1962"},{"key":"132700","doi-asserted-by":"crossref","unstructured":"Chiu H-Y, Hung C-J, Muo C-H, Fan K-C, Sung F-C. The bidirectional association between type 2 diabetes and psoriasis: two retrospective cohort studies. Indian J Dermatol Venereol Leprol 2020; 86: 366.","DOI":"10.4103\/ijdvl.IJDVL_428_18"},{"key":"132701","doi-asserted-by":"crossref","unstructured":"Ohnuma K, Dang NH, Morimoto C. Revisiting an old acquaintance: CD26 and its molecular mechanisms in T cell function. Trends Immunol 2008; 29: 295\u2013301.","DOI":"10.1016\/j.it.2008.02.010"},{"key":"132702","doi-asserted-by":"crossref","unstructured":"Van Lingen R, Van De Kerkhof P, Seyger M, De Jong E, Van Rens D, Poll M, et al. CD26\/dipeptidyl-peptidase IV in psoriatic skin: upregulation and topographical changes. Br J Dermatol 2008; 158: 1264\u20131272.","DOI":"10.1111\/j.1365-2133.2008.08515.x"},{"key":"132703","doi-asserted-by":"crossref","unstructured":"Chiu H-Y, Huang Y-H. Dipeptidyl peptidase-4 inhibitors and the risk of chronic inflammatory skin diseases in type 2 diabetes mellitus in Taiwan: a nationwide population-based cohort study. J Invest Dermatol 2024; 144: 2321\u20132324.","DOI":"10.1016\/j.jid.2024.03.017"},{"key":"132704","doi-asserted-by":"crossref","unstructured":"Kridin K, Amber K, Khamaisi M, Comaneshter D, Batat E, Cohen AD. Is there an association between dipeptidyl peptidase-4 inhibitors and autoimmune disease? A population-based study. Immunol Res 2018; 66: 425\u2013430.","DOI":"10.1007\/s12026-018-9005-8"},{"key":"132705","doi-asserted-by":"crossref","unstructured":"Nishioka T, Shinohara M, Tanimoto N, Kumagai C, Hashimoto K. Sitagliptin, a dipeptidyl peptidase-IV inhibitor, improves psoriasis. Dermatology 2012; 224: 20\u201321.","DOI":"10.1159\/000333358"},{"key":"132706","doi-asserted-by":"crossref","unstructured":"Lynch M, Malara A, Timoney I, Ahern T, Awdeh F, -Sweeney C, et al. Dipeptidyl peptidase-4 inhibition in psoriasis patients with diabetes: a double-blind randomized controlled trial. Dermatology 2021; 237: 66\u201369.","DOI":"10.1159\/000502130"},{"key":"132707","doi-asserted-by":"crossref","unstructured":"Kim SC, Schneeweiss S, Glynn RJ, Doherty M, Goldfine AB, Solomon DH. Dipeptidyl peptidase-4 inhibitors in type 2 diabetes may reduce the risk of autoimmune diseases: a population-based cohort study. Ann Rheum Dis 2015; 74: 1968\u20131975.","DOI":"10.1136\/annrheumdis-2014-205216"},{"key":"132708","doi-asserted-by":"crossref","unstructured":"Lynch M, Ahern TB, Timoney I, Sweeney C, Kelly G, Hughes R, et al. Dipeptidyl peptidase-4 inhibition and narrow-band ultraviolet-B light in psoriasis (DINUP): study protocol for a randomised controlled trial. Trials 2016; 17: 1\u201310.","DOI":"10.1186\/s13063-016-1157-z"},{"key":"132709","doi-asserted-by":"crossref","unstructured":"Cheng CL, Lee CH, Chen PS, Li YH, Lin SJ, Yang YH. Validation of acute myocardial infarction cases in the national health insurance research database in taiwan. J Epidemiol 2014; 24: 500\u2013507.","DOI":"10.2188\/jea.JE20140076"},{"key":"132710","doi-asserted-by":"crossref","unstructured":"Cheng CL, Chien HC, Lee CH, Lin SJ, Yang YH. Validity of in-hospital mortality data among patients with acute myocardial infarction or stroke in National Health Insurance Research Database in Taiwan. Int J Cardiol 2015; 201: 96\u2013101.","DOI":"10.1016\/j.ijcard.2015.07.075"},{"key":"132711","doi-asserted-by":"crossref","unstructured":"Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40: 373\u2013383.","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"132712","doi-asserted-by":"crossref","unstructured":"Lynch M, Tobin AM, Ahern T, O\u2019Shea D, Kirby B. Sitagliptin for severe psoriasis. Clin Exp Dermatol 2014; 39: 841\u2013842.","DOI":"10.1111\/ced.12408"},{"key":"132713","doi-asserted-by":"crossref","unstructured":"Chen Y-C, Chen T-H, Sun C-C, Chen J-Y, Chang S-S, Yeung L, et al. Dipeptidyl peptidase-4 inhibitors and the risks of autoimmune diseases in type 2 diabetes mellitus patients in Taiwan: a nationwide population-based cohort study. 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Reversal of new-onset diabetes through modulating inflammation and stimulating \u03b2-cell replication in nonobese diabetic mice by a dipeptidyl peptidase IV inhibitor. Endocrinology 2010; 151: 3049\u20133060.","DOI":"10.1210\/en.2010-0068"},{"key":"132720","doi-asserted-by":"crossref","unstructured":"Iskandar IYK, Chen TC, Chen LC, Lee MS, Yang YY, Wang TC, et al. Incidence, prevalence, and mortality of people with psoriasis and psoriatic arthritis in Taiwan: a nationwide cohort study. Acta Derm Venereol 2022; 102: adv00807.","DOI":"10.2340\/actadv.v102.1962"},{"key":"132721","doi-asserted-by":"crossref","unstructured":"Jensen P, Ahlehoff O, Egeberg A, Gislason G, Hansen PR, Skov L. Psoriasis and new-onset depression: a Danish nationwide cohort study. 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