October - December 2018, Volume 14, Issue 4

Sayiner ZA, Okyar B, Kisacik B, Akarsu E, Özkaya M, Araz M

DPP-4 Inhibitors Increase the Incidence of Arthritis/Arthralgia but do Not Affect Autoimmunity

Acta Endo (Buc) 2018, 14 (4): 473-476
doi: 10.4183/aeb.2018.473

Aims. In August 2015, FDA published a black box declaring that DPP-4 inhibitors may cause severe joint pains. The impact on autoimmunity marker positivity of these drugs has not been comprehensively evaluated. We compared the incidence of arthritis/arthralgia in patients with T2DM who were using DPP-4 inhibitors and patients who were not using. Methods. A number of 93 DPP-4 inhibitor users and 107 non-users were included into the study. Arthritis/ arthralgia were found in 41 of 93 (44.1%) DPP-4 inhibitor users and in 19 of 107 (17.8%) non-users (p<0.05). Results. No inflammatory rheumatological condition was identified in 27 of 41 (65.9%) patients in DPP-4 inhibitor user group as well as in 13 of 19 (68.4%) patients in non-user group (p>0.05). After adjusting for gender the incidence for arthritis/arthralgia was significantly increased in the DPP-4 inhibitor user group (p value for any DPP-inhibitor <0.05). There was 3.77 times increased risk for arthritis/arthralgia in the DPP-4 inhibitor using group (p value= 0.001) and this risk increases 2.43 times for each year of DPP-4 inhibitor usage. Conclusions. Arthritis/arthralgia were more common among T2DM patients who were using DPP-4 inhibitors compared to non-users, but the seropositivity did not differ between DPP-4 inhibitor users and non-users.

Keywords: Type 2 Diabetes Mellitus, DPP-4 inhibitors, arthralgia/arthritis.

Correspondence: Zeynel Abidin Sayiner, Gaziantep University, Gaziantep, 27100, Turkey, E-mail: zeynelasayiner@hotmail.cominer@hotmail.com