Association of statins, gliptins, and antipsychotics with bullous pemphigoid: A case–control study in the Cretan population

Bullous pemphigoid (BP) is an autoimmune blistering disorder predominantly affecting the elderly. Recently, many studies have shed light on the effect of specific drug intake and comorbidities on the development of BP. The purpose of this study was to investigate the association of specific drug class intake and comorbidities with the development of BP in the Cretan population. Significant associations with BP were found for statins (odds ratio [OR] = 4.06, 95% confidence interval [CI] 1.99–8.27, P < 0.001), gliptins (OR = 4.27, 95% CI 2.33–7.83, P < 0.001), and antipsychotics (OR = 3.33, 95% CI 1.36–8.11, P = 0.006). Higher proportions of use in the BP group vs. control group were found for atorvastatin (OR = 1.86, 95% CI 1.04–3.32, P = 0.035), linagliptin (OR = 6.63, 95% CI 2.17–20.23, P < 0.001), vildagliptin (OR = 3.20, 95% CI 1.73–5.91, P < 0.001), alogliptin (OR = 5.11, 95% CI 1.19–22.04, P = 0.016), and quetiapine (OR = 4.21, 95% CI 1.5–11.85, P = 0.004). The presence of diabetes mellitus in the absence of gliptins did not show any significant effect on BP (OR = 1.60, 95% CI 0.79–3.23, P = 0.188). Metformin intake showed no significant association with BP (OR = 0.48, 95% CI 0.18–1.28, P = 0.143). Our findings confirm and extend previous studies reporting the association of gliptins and antipsychotics on BP in other European populations. The association found for statins is new, thus more studies are needed to corroborate its validity.