DPP 4 inhibitors and IBD

Abstract

Objective To assess whether the use of dipeptidyl peptidase-4 inhibitors is associated with the incidence of inflammatory bowel disease in patients with type 2 diabetes.

Design Population based cohort study.

Setting More than 700 general practices contributing data to the United Kingdom Clinical Practice Research Datalink.

Participants A cohort of 141 170 patients, at least 18 years of age, starting antidiabetic drugs between 1 January 2007 and 31 December 2016, with follow-up until 30 June 2017.

Main outcome measures Adjusted hazard ratios for incident inflammatory bowel disease associated with use of dipeptidyl peptidase-4 inhibitors overall, by cumulative duration of use, and by time since initiation, estimated using time dependent Cox proportional hazards models. Use of dipeptidyl peptidase-4 inhibitors was modelled as a time varying variable and compared with use of other antidiabetic drugs, with exposures lagged by six months to account for latency and diagnostic delays.

Results During 552 413 person years of follow-up, 208 incident inflammatory bowel disease events occurred (crude incidence rate of 37.7 (95% confidence interval 32.7 to 43.1) per 100 000 person years). Overall, use of dipeptidyl peptidase-4 inhibitors was associated with an increased risk of inflammatory bowel disease (53.4 v 34.5 per 100 000 person years; hazard ratio 1.75, 95% confidence interval 1.22 to 2.49). Hazard ratios gradually increased with longer durations of use, reaching a peak after three to four years of use (hazard ratio 2.90, 1.31 to 6.41) and decreasing after more than four years of use (1.45, 0.44 to 4.76). A similar pattern was observed with time since starting dipeptidyl peptidase-4 inhibitors. These findings remained consistent in several sensitivity analyses.

Conclusions In this first population based study, the use of dipeptidyl peptidase-4 inhibitors was associated with an increased risk of inflammatory bowel disease. Although these findings need to be replicated, physicians should be aware of this possible association.

Full text: http://www.bmj.com/content/360/bmj.k872

There is a new study that found dipeptidyl peptidase-4 inhibitors are anti-inflammatory and reduce insulin resistance just not the drugs in the market, but what the naturally the body produce. That why just making a drug to copy is not always the solution. But what they want now? Making another drug.

When they were first invented I recall fears that they would increase cancer because dpp-4 has many functions. Did anything come of that or has it not been studied?

chris c wrote:When they were first invented I recall fears that they would increase cancer because dpp-4 has many functions. Did anything come of that or has it not been studied?

Medications go thru cycles when they are in patent you will see a flurry of positive research coming out. Once the new more expensive kid in the blog appear there will start to appear negative studies and more in dept "research". So everyone have to be move the new best thing.

Yes they seem to be throwing them under the bus now we have farxiga et al.