Vildagliptin-Induced Bullous Pemphigoid: A Retrospective Cohort Study

Bullous pemphigoid (BP) is a common autoimmune blistering disease associated with medications, particularly dipeptidyl peptidase-4 inhibitors such as vildagliptin, funded in New Zealand since 2018. We conducted a retrospective single-centre study of histologically confirmed BP cases between 2018 and 2023. Of 49 patients identified, 15 (30.6%) had vildagliptin-induced BP. Māori patients were over-represented in this subgroup. The mean time to BP onset after vildagliptin initiation was 388 days. Non-vildagliptin BP was more likely to require systemic immunosuppression. Vildagliptin-induced BP represents a common and under-recognised clinical entity in New Zealand.