Emergence of inflammatory bowel disease during treatment with sitagliptin

SUMMARY We present one clinical case of diagnosed inflammatory bowel disease, as a probable adverse reaction to sitagliptin. Sitagliptin is a dipeptidylpeptidase (DPP)-4 inhibitor authorised for the type II diabetes mellitus treatment in adult patients who do not achieve good blood glucose control and if other therapeutic alternatives are not correctly tolerated. In addition to the DPP-4 role in the gastric hormones release and glucose homeostasis, the DPP-4 involvement in the inflammatory response is known. However, the relationship between inflammatory bowel disease (IBD) and inhibition of PPD-4 is controversial. On the one hand, the T lymphocytes of patients with this pathology seem to express high levels of the enzyme DPP-4, so their inhibition could be associated with a decrease in the activity of IBD. On the other hand, in a cohort study of patients treated with oral antidiabetics an increased risk of IBD was observed and there are different published cases of IBD occurrence during the use of sitagliptin.