| アブストラクト | BACKGROUND: Case reports have suggested a link between dipeptidyl peptidase-4 (DPP-4) inhibitors, antidiabetic drugs used as second- to third-line treatments, and incidence of rheumatoid arthritis. Because the DPP-4 enzyme is involved in several immunologic processes and possibly in the pathophysiology of rheumatoid arthritis, further research is warranted. This population-based study aimed to determine whether use of DPP-4 inhibitors is associated with incidence of rheumatoid arthritis. METHODS: Using the United Kingdom Clinical Practice Research Datalink, we conducted a cohort study among 144,603 patients with type 2 diabetes initiating antidiabetic drugs between 2007 and 2016. We estimated hazard ratios (HRs) with 95% confidence intervals (CIs) for incident rheumatoid arthritis using time-dependent Cox proportional hazards models, comparing use of DPP-4 inhibitors with use of other antidiabetic drugs. We imposed a 6-month exposure lag period for latency and diagnostic delays. Secondary analyses included assessment of the duration-response relation and comparison with other second-line antidiabetic drugs, among others. RESULTS: During 567,169 person-years of follow-up, 464 patients were newly diagnosed with rheumatoid arthritis (crude incidence rate: 82 per 100,000/year). Compared with use of other antidiabetic drugs, use of DPP-4 inhibitors was not associated with an increased risk of rheumatoid arthritis (82 vs. 79 per 100,000/year; HR = 1.0; 95% CI = 0.8, 1.3), with no evidence of duration-response relation. The results did not change after using second-line antidiabetic drugs as the comparator group. CONCLUSIONS: In this large population-based study, use of DPP-4 inhibitors was not associated with an increased risk of incident rheumatoid arthritis. |
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| 投稿者 | Douros, Antonios; Abrahami, Devin; Yin, Hui; Yu, Oriana Hoi Yun; Renoux, Christel; Hudson, Marie; Azoulay, Laurent |
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| 組織名 | From the Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General;Hospital, Montreal, Canada.;Department of Epidemiology, Biostatistics, and Occupational Health, McGill;University, Montreal, Canada.;Institute of Clinical Pharmacology and Toxicology, Charite - Universitatsmedizin;Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universitat zu;Berlin, and Berlin Institute of Health, Berlin, Germany.;Division of Endocrinology, Jewish General Hospital, Montreal, Canada.;Department of Neurology and Neurosurgery, McGill University, Montreal, Canada.;Division of Rheumatology, Jewish General Hospital, Montreal, Canada.;Department of Medicine, McGill University, Montreal, Canada.;Gerald Bronfman Department of Oncology, McGill University, Montreal, Canada. |
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