摘要
糖尿病已成為臺灣新國病，而新型口服降血糖藥物dipeptidyl peptidase-4 inhibitor（DPP-4 inhibitor）已成為臨床使用的趨勢。過去常見副作用為腸胃相關問題，但近幾年陸續發生DPP-4 inhibitor引發類天疱瘡的個案。類天疱瘡是一種自體免疫水泡疾病，需要用到系統性類固醇及其他免疫抑制劑的治療，很容易產生感染甚至敗血症等併發症。由於全身長滿水泡，對於病人、家屬的照護上是很大的負擔。雖然目前詳細機轉並不明確，但如能越早排除DPP-4 inhibitor引發的類天疱瘡，即時停掉DPP-4 inhibitor的使用，可以降低為治療類天疱瘡而使用的類固醇劑量，減少併發症的產生。
參考文獻
1. American Diabetes Association. Standards of medical care in diabetes—2018 abridged for primary care providers. Clin Diabetes 2018;36:14-37.
3. Adrian V. Mechanism of Action of DPP-4 Inhibitors—New Insights. J Clin Endocrinol Metab 2012;97:2626-8
4. Skandalis K, Spirova M, Gaitanis G, et al. Drug-induced bullous pemphigoid in diabetes mellitus patients receiving dipeptidyl peptidase-IV inhibitors plus metformin. JEADV 2012;26,249-53.
6. Langan SM, Groves RW, West J. The relationship between neurological disease and bullous pemphigoid: a population-based case-control study. J Invest Dermatol 2011;131:631-6.
7. Brick KE, Weaver CH, Savica R et al. A population-based study of the association between bullous pemphigoid and neurologic disorders. J Am Acad Dermatol 2014; 71:1191-7.