Association between sodium‐glucose co‐transporter 2 inhibitors and risk of bullous pemphigoid in patients with type 2 diabetes: a nationwide population‐based cohort study

Ma, Sheng‐Hsiang; Wu, Chia-Chun; Lyu, YS; Chou, YJ; Yt, Chang

doi:10.1111/jdv.18106

Cited by 5 publications

(2 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A retrospective Finnish population study of BP patients aged over 40 years, did not show any increased risk associated with SGLT‐2 inhibitors 17 . A cohort study of diabetic patients taking SGLT‐2 inhibitors showed a lower risk of BP (HR 0.56), compared to diabetic patients without SGLT‐2 usage, after adjusting for confounders 18 . Interestingly, a pooled analysis of five randomised controlled trials found that combination therapy with empagliflozin and linaglipin had a similar incidence of adverse events compared to monotherapy and no cases of pemphigoid were reported within the 2895 patients analysed 19 .…”

Section: Discussionmentioning

confidence: 95%

“… 17 A cohort study of diabetic patients taking SGLT‐2 inhibitors showed a lower risk of BP (HR 0.56), compared to diabetic patients without SGLT‐2 usage, after adjusting for confounders. 18 Interestingly, a pooled analysis of five randomised controlled trials found that combination therapy with empagliflozin and linaglipin had a similar incidence of adverse events compared to monotherapy and no cases of pemphigoid were reported within the 2895 patients analysed. 19 However, there is one case report from Japan diagnosing BP 5‐months after ipragliflozin.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bullous pemphigoid in a patient with a neuropsychological disorder and a possible novel drug trigger: A case report and review of the literature

Dyson

Patel

Igali

et al. 2022

Skin Health and Disease

View full text Add to dashboard Cite

A 59‐year‐old woman with schizoaffective disorder presented with an itchy, blistering generalised rash. One month prior, she had started empagliflozin, a sodium glucose transporter‐2 (SGLT‐2) inhibitor, used in type‐2‐diabetes. She was already established on paliperidone, an atypical antipsychotic, for 1 year. Serology at presentation was positive for anti‐pemphigoid antibodies. Histology demonstrated subepidermal blistering, perivascular inflammation and eosinophils. Direct immunofluorescence was characteristic of bullous pemphigoid (BP), with linear IgG and C3 at the basement membrane. Both empagliflozin and paliperidone were discontinued. However, the blisters persisted. Treatment included: topical Dermovate and Eumovate ointment for the body and face respectively, alongside oral doxycycline 200 mg and prednisolone 40 mg for a week (reducing by 5 mg/week over 8 weeks). Nevertheless, new blisters continued developing, hence dapsone 50 mg was introduced, with significant improvement. Increasingly, several neurological and psychiatric disorders have been linked with BP, complicating aetiology and management. The underlying mechanism for these associations is not fully understood. Bullous pemphigoid autoantigens BP180 and BP230 are expressed in the central nervous system and it is thought that neurodegeneration may expose antigens to the immune system, generating a cross‐reactive immune response. However, there also appears to be bidirectional causality between BP and neuropsychological conditions. Furthermore, as there was an association of empagliflozin initiation and BP onset, this further complicates the aetiology and presents a potential novel drug cause of BP. This case emphasises the neuropsychological issues associated with managing complex BP cases, a possible novel cause of drug‐induced BP and highlights the likelihood of these issues becoming increasingly prevalent for the future.

show abstract

Section: Discussionmentioning

confidence: 95%