DPP-4 Inhibitors Confer Some Risk for Gallbladder and Biliary Disease

Dipeptidyl peptidase-4 (DPP-4) inhibitors increase the bioavailability of endogenous glucagon-like peptide-1 (GLP-1). Both DPP-4 inhibitors and GLP-1–receptor agonists are useful in managing diabetes, but increased GLP-1 also might affect gallbladder motility and contribute to gallbladder or biliary disease. Several studies have associated GLP-1 receptor agonists with excess gallbladder or biliary disease, but the evidence regarding DPP-4 inhibitors has been unclear.

In a meta-analysis, researchers combined the results of 82 randomized trials in which DPP-4 inhibitors were compared with control drugs (other than GLP-1 agonists or other DPP-4 inhibitors) or placebo in >100,000 adults with type 2 diabetes. Compared with control agents, DPP-4 i…