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Adverse Effects of Incretin Therapy for Type 2 Diabetes—Reply
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In Reply: The findings previously reported by Dr Grouzmann and colleagues regarding DPP4 activity in nasal tissues and the effect of DPP4 on substance P in patients with chronic rhinosinusitis provide a potential explanation and support for our clinical findings of increased risk of nasopharyngitis and headache in patients with type 2 diabetes treated with DPP4 inhibitors. In our review, we included only publicly available data from the published literature, which did not specify whether there was overlap among patients reporting nasopharyngitis and headache. Therefore, we cannot determine whether, in patients treated with DPP4 inhibitors, headache is a component of nasopharyngitis or if it constitutes a distinct clinical entity. We agree that it would be reasonable for clinicians to be cautious when using DPP4 inhibitors in patients with chronic rhinosinusitis or headache.
Financial Disclosures: None reported.
Anastassios G. Pittas, MD, MSc
apittas@tufts-nemc.org
Renee E. Amori, MD
Division of Endocrinology, Diabetes and Metabolism
Joseph Lau, MD
Institute for Clinical Research and Health Policy Studies
Tufts–New England Medical Center
Boston, Massachusetts
Letters Section Editor: Robert M. Golub, MD, Senior Editor.
JAMA. 2007;298:1760.
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