title: Sitagliptin (DPP-4 inhibitor)-induced rheumatoid arthritis in type 2 diabetes mellitus: a case report.
abstract: A dipeptidyl peptidase (DPP)-4 inhibitor, commonly used to treat patients with type 2 diabetes, has caused concern because of immune system side effects. We report a 48-year-old woman with type 2 diabetes who was diagnosed with rheumatoid arthritis (RA) after continued polyarthritis and an increase in rheumatoid factor up to 86 IU/mL after three months of treatment with sitagliptin, a DPP-4 inhibitor. The shared epitope (SE)-containing human leukocyte antigen (HLA)-DRB1 alleles, which are important predisposing factors for RA, were positive. RA might have been triggered by sitagliptin due to a predisposing condition.
authors.affiliation: Kobe University Graduate School of Medicine, Japan. yoyochibiakiko@yahoo.co.jp
authors.forename: Kazuki
authors.initials: K
authors.lastname: Yokota
authors.forename: Naoya
authors.initials: N
authors.lastname: Igaki
mesh_terms: D000483:Alleles; D001172:Arthritis, Rheumatoid / Q000209:etiology* / Q000235:genetics / Q000276:immunology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000009:adverse effects; D005260:Female; D020022:Genetic Predisposition to Disease; D059811:HLA-DRB1 Chains / Q000235:genetics / Q000276:immunology; D006801:Humans; D008875:Middle Aged; D011719:Pyrazines / Q000009:adverse effects*; D012217:Rheumatoid Factor / Q000097:blood; D000068900:Sitagliptin Phosphate; D014230:Triazoles / Q000009:adverse effects*
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D059811:HLA-DRB1 Chains; D011719:Pyrazines; D014230:Triazoles; D012217:Rheumatoid Factor; D000068900:Sitagliptin Phosphate