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Adverse Effects of Incretin Therapy for Type 2 Diabetes
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To the Editor: In their meta-analysis studying the efficacy and safety of incretin therapy in persons with type 2 diabetes, Dr Amori and colleagues1 found that patients treated with dipeptidyl peptidase 4 (DPP4) inhibitors had an increased risk of nasopharyngitis (6.4% for DPP4 inhibitors vs 6.1% for comparator; risk ratio, 1.2; 95% confidence interval, 1.0-1.4). This adverse effect is consistent with our finding that DPP4 enzymatic activity in nasal tissue biopsies taken from patients with chronic rhinosinusitis was inversely correlated with the density of inflammatory cells in the nasal mucosa, and the DPP4 activity increased when chronic sinusitis was treated.2
Dipeptidyl peptidase 4 inactivates the proinflammatory peptide substance P that is released by sensory nerve fibers of the nasal mucosa during neurogenic inflammation. In pigs, the administration of recombinant DPP4 considerably attenuated the proinflammatory effect of histamine and capsaicin that causes the release of substance P, as well as the . . . [Full Text of this Article]
Eric Grouzmann, PharmD, PhD
eric.grouzmann@chuv.ch
Division de Pharmacologie et Toxicologie Cliniques
Michel Monod, PhD
Service de Dermatologie
Centre Hospitalier Universitaire Vaudois
Lausanne, Switzerland
Basil N. Landis, MD;
Jean-Silvain Lacroix, MD, PhD
Rhinology-Olfactology Unit
Department of Otolaryngology
University Hospital of Geneva
Geneva, Switzerland
RELATED LETTER
Adverse Effects of Incretin Therapy for Type 2 Diabetes—Reply
Anastassios G. Pittas, Renee E. Amori, and Joseph Lau
JAMA. 2007;298(15):1760.
EXTRACT
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RELATED ARTICLE
Efficacy and Safety of Incretin Therapy in Type 2 Diabetes: Systematic Review and Meta-analysis
Renee E. Amori, Joseph Lau, and Anastassios G. Pittas
JAMA. 2007;298(2):194-206.
ABSTRACT
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