DPP-4 inhibitors and risk of infections: a meta-analysis of randomized controlled trials
Wenjia Yang1, Xiaoling Cai1, Xueyao Han1
1Endocrinology and Metabolism Department, Peking University People's Hospital, Beijing, China.
Background:
To evaluate the risk of infections in the treatment of type 2 diabetes patients with dipeptidyl-peptidase 4 (DPP-4) inhibitors.
Methods:
A literature search was conducted through electronic databases. The inclusion criteria included study duration of no less than 12 weeks developed in type 2 diabetes patients, the use of a randomized control group receiving a DPP-4 inhibitor and the availability of outcome data for infections. Out of 2181 studies, 74 studies were finally included.
Results:
The risk of overall infection for DPP-4 inhibitors treatment was comparable to placebo (odds ratio (OR) = 0.97, 95% confidence interval (CI), 0.91 to 1.04, p = 0.40), metformin treatment (OR = 1.22, 95% CI, 0.95 to 1.56, p = 0.12), sulphonylurea treatment (OR = 1.09, 0.93 to 1.29, p = 0.29), thiazolidinedione treatment (OR = 0.86, 95% CI, 0.65 to 1.14, p = 0.29) and alpha glucosidase inhibitor treatment (OR = 1.03, 95% CI, 0.33 to 3.22, p = 0.96). When compared different DPP-4 inhibitors with placebo treatment, risks of infections were comparable for alogliptin, linagliptin, sitagliptin, saxagliptin and vildagliptin. Compared with placebo or active comparator treatment, risks of infection in different systems for DPP-4 inhibitors were all comparable.
Conclusions:
The overall risk of infections of DPP-4 inhibitor was not increased compared with control groups.
Insights
Dipeptidyl-peptidase 4 (DPP-4) inhibitors for type 2 diabetes do not increase infection risk. This meta-analysis found comparable infection rates with DPP-4 inhibitors versus placebo and other diabetes treatments.
Area of Science:
- Endocrinology
- Pharmacology
- Infectious Diseases
Background:
- Type 2 diabetes management often involves medications like dipeptidyl-peptidase 4 (DPP-4) inhibitors.
- Concerns exist regarding the potential for increased infection risk with DPP-4 inhibitor therapy.
Purpose of the Study:
- To evaluate the risk of infections in patients with type 2 diabetes treated with DPP-4 inhibitors.
- To compare infection risks associated with DPP-4 inhibitors against placebo and other common antidiabetic drug classes.
Main Methods:
- A comprehensive literature search was performed across electronic databases.
- Inclusion criteria specified a minimum study duration of 12 weeks, type 2 diabetes patients, a randomized controlled group using a DPP-4 inhibitor, and available infection outcome data.
- Seventy-four studies were included from an initial pool of 2181.
Main Results:
- The overall risk of infection with DPP-4 inhibitors was comparable to placebo (OR=0.97, 95% CI 0.91-1.04).
- Infection risks were also comparable when DPP-4 inhibitors were compared to metformin, sulfonylurea, thiazolidinedione, and alpha-glucosidase inhibitors.
- Specific DPP-4 inhibitors (alogliptin, linagliptin, sitagliptin, saxagliptin, vildagliptin) showed comparable infection risks to placebo, as did infections across different body systems.
Conclusions:
- DPP-4 inhibitor treatment for type 2 diabetes does not elevate the overall risk of infections.
- The findings suggest that DPP-4 inhibitors are a safe option regarding infection risk in type 2 diabetes management.
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