Current Perspectives for Oral Hypoglycemic Agents with Clinical Evidence of Larger Studies.
The episodes of hypoglycemia are risk factors for cardiovascular prognosis.
A cohort study examining the prognosis of 74,610 patients for type 2 diabetes mellitus was reported.
After follow-up of 7.1-years in median, the absolute 5-year risk of death was 6.6% for cardiovascular death,
1.1% for cancer deaths, and 13.1% for other deaths in hospitalized group for severe hypoglycemia, respectively.
In contrast, the group who was not hospitalized for severe hypoglycemia had
cardiovascular deaths 4.7%, cancer deaths 1.4%, and other deaths
11.1%, which were lower than those who experienced hypoglycemia, respectively.
As a result, no additional benefit to cardiovascular risk could be expected
when DPP-4i was added to standard treatment. Some studies are
found concerning DPP-4i and bullous pemphigoid.
For 138 RCTs, including 61514 DPP-4 inhibitor users and 59661 subjects
were analyzed. Among them, only 6 studies reported BP. As a result of meta-analysis,
an odds ratio of 4.44 was found to be significantly associated with this risk.
Meta-analysis study was conducted for evaluating the risk of BP and skin-related adverse
events. Totally, 46 randomized placebo-controlled trials were included.
Among them, 3 studies revealed BP, which included AEs.
Comparison with control group, DPP4i group showed significantly higher-risk.
Moreover, DPP-4i therapy revealed increased overall risk of AEs.
To evaluate the relationship for BP, 5 studies for different kinds of DPP-4i were analyzed.
From adjusted meta-analysis, significant association between them were observed as OR
2.13. The OR was 5.08 in vildagliptin, 2.87 in Lina gliptin, while OR 1.29 in sitagliptin.
By subgroup analysis, the OR in male was 2.35 and 1.88 in female.
Consequently, the adjusted analysis can support a significant association of DPP-4i use and BP.
Diabetes Res Open J. 2021; 7(1): e1-e3. doi: 10.17140/DROJ-7-e016
