title: Dipeptidyl Peptidase (DPP)-4 Inhibitor-Induced Arthritis/Arthralgia: A Review of Clinical Cases.
abstract: Dipeptidyl peptidase (DPP)-4 inhibitors are a class of oral drugs used for the treatment of type 2 diabetes mellitus (T2DM). The pharmacological inhibition of DPP-4 seems to also induce adverse events related to cytokine-induced inflammation. Recently, several clinical cases regarding the association of DPP-4 inhibitors and the onset of arthritis/arthralgia have been reported in the literature. Various mechanisms could be responsible for DPP-4 inhibitor-induced arthritis/arthralgia, and the increase of cytokines, chemokines, matrix metalloproteinases (MMPs) and genetic factors plays an important role. The US FDA published a safety announcement regarding the entire drug class, encouraging healthcare professionals and patients to pay attention to the occurrence of arthralgia during treatment with DPP-4 inhibitors; arthralgia could be assessed as a class adverse drug event for DPP-4 inhibitors. To summarize the evidence on the correlation between DPP-4 inhibitors and arthritis/arthralgia, and to explain the measures taken by the FDA with regard to arthralgia risk, we performed a literature review of recent evidence concerning this association. This review shows the necessity of other studies to better define the association between DPP-4 inhibitors and arthritis/arthralgia.
authors.affiliation: Section of Pharmacology, Department of Experimental Medicine, Pharmacoepidemiology and Pharmacovigilance Centre of the Campania Region, Second University of Naples, via L. de Crecchio 7, 80138, Naples, Italy. annamaria.mascolo@unina2.it.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Mascolo
authors.affiliation: Section of Pharmacology, Department of Experimental Medicine, Pharmacoepidemiology and Pharmacovigilance Centre of the Campania Region, Second University of Naples, via L. de Crecchio 7, 80138, Naples, Italy.
authors.forename: Concetta
authors.initials: C
authors.lastname: Rafaniello
authors.affiliation: Section of Pharmacology, Department of Experimental Medicine, Pharmacoepidemiology and Pharmacovigilance Centre of the Campania Region, Second University of Naples, via L. de Crecchio 7, 80138, Naples, Italy.
authors.forename: Liberata
authors.initials: L
authors.lastname: Sportiello
authors.affiliation: Section of Pharmacology, Department of Experimental Medicine, Pharmacoepidemiology and Pharmacovigilance Centre of the Campania Region, Second University of Naples, via L. de Crecchio 7, 80138, Naples, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Sessa
authors.affiliation: Section of Pharmacology, Department of Experimental Medicine, Pharmacoepidemiology and Pharmacovigilance Centre of the Campania Region, Second University of Naples, via L. de Crecchio 7, 80138, Naples, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Cimmaruta
authors.affiliation: Section of Pharmacology, Department of Experimental Medicine, Pharmacoepidemiology and Pharmacovigilance Centre of the Campania Region, Second University of Naples, via L. de Crecchio 7, 80138, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Rossi
authors.affiliation: Section of Pharmacology, Department of Experimental Medicine, Pharmacoepidemiology and Pharmacovigilance Centre of the Campania Region, Second University of Naples, via L. de Crecchio 7, 80138, Naples, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Capuano
mesh_terms: D000818:Animals; D018771:Arthralgia / Q000139:chemically induced*; D001168:Arthritis / Q000139:chemically induced*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D018819:Dipeptidyl Peptidase 4 / Q000378:metabolism*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D018819:Dipeptidyl Peptidase 4