GPs should refrain from prescribing a diabetes drug for patients at high risk of developing inflammatory bowel disease, according to a new study.
Researchers from Canada and Germany found that taking DPP-4 inhibitors was linked to a 75% increased risk of developing the condition.
They compared UK patients taking the inhibitors with those taking other diabetes drugs, across more than 700 practices.
They found that the incidence of IBD was significantly increased for those taking the DPP-4 inhibitors and said that doctors needed to be made aware of this.
Published in the BMJ, the research analysed the data of over 140,000 adult patients who were starting antidiabetic drugs between 2007 and 2016.
Patients who had initially been treated with insulin as well as those with a history of IBD or a similar condition were excluded, and factors such as age, weight, smoking status and complications of diabetes were taken into account.
The team monitored the participants for an average of three and a half years, noting how many developed IBD.
They saw that the number of cases in the DPP-4 inhibitor group was 53.4 per 100 000 people per year, while for the other drugs it was much lower at 34.5.
The paper said: ‘Compared with use of other antidiabetic drugs, use of dipeptidyl peptidase-4 inhibitors was associated with a 75% increase in risk of inflammatory bowel disease’.
This risk increased with the length of drug use, which peaked after three to four years.
Researchers said that while the findings require replication, ‘physicians should be made aware of this possible association and perhaps refrain from prescribing dipeptidyl peptidase-4 inhibitors for people at high risk, that is, those with a family history of disease or with known autoimmune conditions’.
They also warned that patients presenting with persistent gastrointestinal symptoms such as abdominal pain or diarrhoea, should be carefully monitored to see if their symptoms worsen.
However, the team also acknowledged that while they had adjusted for several risk factors, they could not rule out the possibility that other confounding factors could have influenced the results.
Companies who have developed DPP-4 inhibitors have previously attempted to show their cardiovascular benefit, however data released in 2013 from two large, placebo-controlled trials showed that the drugs did not have any impact in that area