DPP-4 INHIBITORS INCREASE THE INCIDENCE OF ARTHRITIS/ARTHRALGIA BUT DO NOT AFFECT AUTOIMMUNITY

Area of Science:

• Endocrinology
• Rheumatology
• Pharmacology

Background:

• FDA issued a black box warning in 2015 regarding DPP-4 inhibitors and severe joint pain.
• The effect of DPP-4 inhibitors on autoimmunity markers in patients with type 2 diabetes (T2DM) requires further investigation.

Purpose of the Study:

• To compare the incidence of arthritis/arthralgia in T2DM patients using DPP-4 inhibitors versus non-users.
• To evaluate the impact of DPP-4 inhibitors on autoimmunity marker positivity.

Main Methods:

• Retrospective study comparing 93 DPP-4 inhibitor users and 107 non-users with T2DM.
• Incidence of arthritis/arthralgia and seropositivity for rheumatological conditions were assessed.

Main Results:

• Arthritis/arthralgia occurred in 44.1% of DPP-4 inhibitor users vs. 17.8% of non-users (p<0.05).
• No significant difference in inflammatory rheumatological conditions or seropositivity was observed between groups.
• Adjusted analysis revealed a significantly increased incidence of arthritis/arthralgia in DPP-4 inhibitor users (p<0.05).
• The risk of arthritis/arthralgia was 3.77 times higher in DPP-4 inhibitor users (p=0.001), increasing by 2.43 times per year of use.

Conclusions:

• Arthritis/arthralgia are more common in T2DM patients using DPP-4 inhibitors compared to non-users.
• DPP-4 inhibitor use did not significantly affect seropositivity for autoimmune markers.