Category: Federal Forum Posters
Purpose: Dipeptidyl peptidase 4 (DPP-4) inhibitors are a popular second-line treatment for Type 2 diabetes mellitus. Several studies have reported on the association between DPP-4 inhibitors and the risk of developing inflammatory bowel disease (IBD) with conflicting results. This meta-analysis aims to elucidate the risk for IBD with DPP-4 inhibitor therapy.
Methods: A comprehensive search of PubMed/MEDLINE, CINAHL, the Cochrane Database, ClinicalTrials.gov, and the European Clinical Trials Database was performed (June 2018). All controlled clinical trials and observational studies of DPP-4 inhibitors that reported events of IBD, Crohn’s disease (CD), ulcerative colitis (UC) or colitis and had a duration greater than or equal to 52 weeks were included. The DerSimonian and Laird random effects model was utilized to assess the relative risk for IBD post DPP-4 inhibitor exposure.
Results: 16 individual studies evaluating a total of 198,404 patients were included for analysis. Studies ranged from 52 weeks through 5 years. DPP-4 inhibitor exposure resulted in a non-significant increase in the risk of IBD (relative risk [RR] 1.52, 95 percent CI 0.72 to 3.24), I2 equals 54.2 percent). DPP4 inhibitor use significantly increased the risk of Crohn’s disease (RR 2.47, 95 percent CI 1.36 to 4.48) and this effect was also seen in studies not sponsored by the pharmaceutical industry (RR 3.37, 95 percent CI 1.15 to 9.86). These findings were driven by the inclusion of one large study.
Conclusion: DPP-4 inhibitor exposure was not associated with an increased risk of developing inflammatory bowel disease. However, long-term post-marketing surveillance is warranted.
Joshua Radel– AFIT Pharmacy Resident, University of Pittsburgh School of Pharmacy, Vacaville, CA