title: Dipeptidyl peptidase-4 inhibitors and the risk of community-acquired pneumonia in patients with type 2 diabetes.
abstract: OBJECTIVE
  To determine whether the use of dipeptidyl peptidase-4 (DPP-4) inhibitors is associated with an increased risk of community-acquired pneumonia.
  
  
  METHODS
  The UK Clinical Practice Research Datalink and the Hospital Episodes Statistics database were used to conduct a nested case-control analysis within a cohort of new users of antidiabetic drugs between 2007 and 2012. Incident cases of hospitalization for community-acquired pneumonia were matched with up to 20 controls on age, duration of treated diabetes, calendar year and duration of follow-up. Conditional logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for hospitalization for community-acquired pneumonia associated with current use of DPP-4 inhibitors compared with current use of two or more oral antidiabetic drugs.
  
  
  RESULTS
  The cohort included 49,653 patients, of whom 562 were hospitalized for community-acquired pneumonia during follow-up (incidence rate 5.2/1000 person-years). Compared with current use of two or more oral antidiabetic drugs, current use of DPP-4 inhibitors was not associated with an increased risk of hospitalized community-acquired pneumonia overall (adjusted OR 0.80, 95% CI 0.50-1.29) or according to duration of use (p for trend = 0.57).
  
  
  CONCLUSIONS
  The use of DPP-4 inhibitors was not associated with an increased risk of hospitalization for community-acquired pneumonia. Additional research is needed to assess the association between these drugs and other serious infections.
authors.affiliation: Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada; Department of Pharmacoepidemiology, INSERM U1027, Faculty of Medicine, Paul Sabatier University, Toulouse, France; Department of Medical Pharmacology and Toxicology, Pharmacovigilance Regional Center, CHRU Montpellier University Hospital, Montpellier, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Faillie
authors.forename: K B
authors.initials: KB
authors.lastname: Filion
authors.forename: V
authors.initials: V
authors.lastname: Patenaude
authors.forename: P
authors.initials: P
authors.lastname: Ernst
authors.forename: L
authors.initials: L
authors.lastname: Azoulay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D017714:Community-Acquired Infections / Q000150:complications / Q000453:epidemiology / Q000276:immunology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000276:immunology; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D060467:Disease Resistance / Q000187:drug effects*; D057286:Electronic Health Records; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications / Q000453:epidemiology / Q000276:immunology*; D012306:Risk; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors
keywords: DPP-IV inhibitor; database research; pharmaco-epidemiology; type 2 diabetes