In patients with type 2 diabetes, the use of dipeptidyl peptidase-4 (DPP-4) inhibitors is not associated with the development of inflammatory bowel disease, according to study results published in Diabetes Care.

Researchers of this meta-analysis study evaluated randomized control trials for an association between DPP-4 inhibitors and inflammatory bowel disease in patients with type 2 diabetes. PubMed, Embase, the Cochrane Central Register of Controlled Trials, and databases were used to identify trials involving patients with type 2 diabetes who were receiving DPP-4 inhibitors and had reported inflammatory bowel disease.

Of 13 trials identified for inclusion, 8 were placebo-controlled and 5 were active-controlled. Overall, there were 54,719 patients included in the trials who had a mean age of 60.9 years, mean duration of diabetes of 9.3 years, baseline hemoglobin A1c of 7.8%, and 39 reported events of inflammatory bowel disease.

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Using a random-effects model, the estimated relative risk for inflammatory bowel disease was similar for patients receiving DPP-4 inhibitors and control participants (relative risk [RR], 1.01; 95% CI, 0.30-3.41). However, the risk for Crohn disease was lower (RR, 0.75; 95% CI, 0.21-2.66) and risk for ulcerative colitis was higher (RR, 2.98; 95% CI, 0.31-28.6) in patients receiving DPP-4 inhibitors.

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The researchers concluded that the results from the meta-analysis indicated no association between DPP-4 inhibitor use and inflammatory bowel disease risk for patients with type 2 diabetes.

“However, given the relatively low number of trials and events as well as potential trial bias, we cannot definitively exclude the possibility of a weak association,” wrote the investigators.


Li G, Crowley MJ, Tang H, Yang JY, Sandler RS, Wang T. Dipeptidyl peptidase 4 inhibitors and risk of inflammatory bowel disease among patients with type 2 diabetes: a meta-analysis of randomized controlled trials [published online May, 21, 2019]. Diabetes Care. doi:10.2337/dc18-1578

This article originally appeared on Endocrinology Advisor