Do dipeptidyl peptidase-4 (DPP-4) inhibitors increase the risk of joint pain?

 This study compared data from clinical trials investigating if dipeptidyl peptidase-4 (DPP-4) inhibitors are associated with a greater risk of arthralgia (joint pain) in type 2 diabetes patients.

They found there was slight increased risk for developing arthralgia in patients taking DPP-4 inhibitors.

Managing blood sugar levels is crucial in type 2 diabetes. There are many medications to manage blood sugar levels that act in different ways. Dipeptidyl peptidase-4 (DPP-4) inhibitors reduce blood sugar by increasing the levels of two peptides that stimulate the release of insulin. Insulin, in turn, reduces blood sugar levels.

DDP-4 inhibitors are effective in patients that do not respond well to the standard first line of treatment, metformin. There is evidence that DPP-4 inhibitors may increase the risk of arthralgia (joint pain and inflammation). This study compared data from a range of studies investigating the association between DDP-4 inhibitor use and arthralgia. 

This study analyzed the findings of 67 trials, including 79,110 patients with type 2 diabetes. Some patients received DPP-4 inhibitors alone or in combination with other glucose-lowering medications. They examined the reports of adverse events from each study to determine the incidence of arthralgia in patients receiving DPP-4 inhibitor treatment.

DPP-4 inhibitors were associated with a slight increased risk of arthralgia overall (13%). DPP-4 inhibitor combination treatment was associated with a slight increased risk. Treatment with DPP-4 inhibitors alone was not. Patients with a longer duration of diabetes (more than 5 years) had a greater risk of arthralgia. 

This study concluded that DPP-4 inhibitors are associated with a slight increased risk of arthralgia in patients with type 2 diabetes.

Diabetes disease severity was not consistently reported in some trials and may impact the results reported here. 

If you have any concerns regarding blood glucose management then please discuss with your doctor.