Chung-Yi Li
National Cheng Kung University, Taiwan
This is the first large longitudinal cohort study to investigate the putative association of severe joint pain (SJP) with dipeptidyl peptidase-4 inhibitor (DPP4i) use in patients with type 2 diabetes. The propensity score-matched population-based cohort study was performed between 2009 and 2013 in a group of type 2 diabetes patients with stable metformin use. In total, 4,743 type 2 diabetes patients used a DPP4i as the second-line antidiabetic drug (i.e., DPP4i users) and the same number of matched non-DPP4i users was selected. Two study groups were followed up until SJP diagnosis (international classification of diseases, ninth reversion, clinical modification code 719.4), health insurance policy termination, or the end of 2013. The incidence rate of SJP was estimated under the Poisson assumption. Multiple cox proportional hazard model was used to estimate the covariate-adjusted hazard ratio (HR) and 95% CI of SJP in association with DPP4i use. Over a maximum follow-up of five years, 679 DPP4i users and 767 non-DPP4i users were newly diagnosed with SJP, representing incidence rates of 47.20 and 50.66 per 1,000 person-years, respectively. Cox proportional hazard model indicated that DPP4i use slightly but non-significantly reduced the risk of SJP (adjusted HR: 0.92 [95% CI: 0.83â?? 1.02]). Such null results were also observed among all age and sex stratifications and in a sensitivity analysis using all nonspecific arthropathies as the study endpoint. This study provides no support for the putative risk of SJP related to DPP4i use in type 2 diabetes patients during a maximum follow-up of five years.
Email: cyli99@mail.ncku.edu.tw
