Dipeptidyl Peptidase-4 Inhibitors and Inflammatory Bowel Disease Risk: A Meta-analysis

Document Type

Article

Publication Title

Annals of Pharmacotherapy

ISSN

1060-0280

Volume

53

Issue

7

DOI

10.1177/1060028019827852

First Page

697

Last Page

704

Publication Date

7-1-2019

Abstract

BACKGROUND: 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.

OBJECTIVE: 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 (December 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 ≥52 weeks were included. The DerSimonian and Laird random-effects model was utilized to assess the relative risk (RR) for IBD post DPP-4 inhibitor exposure.

RESULTS: A total of 16 individual studies evaluating a total of 198 404 patients were included for analysis. Studies ranged from 52 weeks through 5 years. In the primary random-effects analysis, DPP-4 inhibitor exposure resulted in a nonsignificant increase in the risk of IBD (RR = 1.52; 95% CI = 0.72 to 3.24; I

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