{"id":20878,"date":"2026-07-31T10:33:28","date_gmt":"2026-07-31T10:33:28","guid":{"rendered":"https:\/\/woncaeurope2026.org\/sessions\/bullous-pemphigoid-induced-by-gliptins-successful-management-with-dupilumab\/"},"modified":"2026-07-31T10:33:28","modified_gmt":"2026-07-31T10:33:28","slug":"bullous-pemphigoid-induced-by-gliptins-successful-management-with-dupilumab","status":"publish","type":"wsa_session","link":"https:\/\/woncaeurope2026.org\/fr\/sessions\/bullous-pemphigoid-induced-by-gliptins-successful-management-with-dupilumab\/","title":{"rendered":"Bullous Pemphigoid induced by gliptins: Successful management with Dupilumab"},"content":{"rendered":"<p>Bullous pemphigoid (BP) is the most common autoimmune blistering disease in elderly patients. DPP-4 inhibitors (gliptins) have emerged as significant triggering factors, with a 2-3 fold increased risk. We present a case successfully managed with biological therapy after corticosteroid-related complications.A 74-year-old male with type 2 diabetes (on linagliptin since October 2024), hypertension, and COPD presented in January 2025 with progressive pruritic lesions evolving over two months. Examination revealed generalized eczematous plaques with tense and flaccid blisters on trunk and extremities, plus oral hemorrhagic bullae. Skin biopsy with direct immunofluorescence demonstrated linear C3 (+++), IgG (++), and IgM (+) deposition at the basement membrane zone. Anti-BP180 antibodies confirmed the diagnosis. Initial treatment consisted of linagliptin withdrawal, prednisone 60mg\/day (0.75mg\/kg\/day), and topical triamcinolone 0.1%. Despite appropriate dosing, the patient showed limited response with persistent new blister formation. Critically, he developed a D6 vertebral fracture in April 2025, a severe corticosteroid complication. Given disease refractoriness, diabetes comorbidity, and corticosteroid-related morbidity, dupilumab was initiated (600mg loading dose, then 300mg bi-weekly). This enabled rapid corticosteroid tapering to 5mg\/day within four months, with complete clinical remission maintained at six-month follow-up.While dupilumab is approved for atopic dermatitis, its use in BP remains off-label despite growing evidence. This case uniquely demonstrates dupilumab&#039;s dual benefit: achieving disease control while preventing further corticosteroid complications in a high-risk patient with multiple comorbidities.This case highlights three critical points: (1) maintaining high clinical suspicion for gliptin-induced BP in diabetic patients with new-onset bullous eruptions; (2) early consideration of steroid-sparing agents in elderly patients with significant comorbidities; (3) dupilumab&#039;s potential as first-line therapy in selected cases rather than salvage treatmentGliptin-induced BP requires prompt recognition and drug withdrawal. Traditional high-dose corticosteroids pose significant risks in elderly diabetic patients. Dupilumab emerges as an effective steroid-sparing alternative, achieving rapid disease control while minimizing complications. Further research should establish optimal timing for biological therapy initiation in high-risk populations.Dupilumab offers a paradigm shift in BP management, particularly for patients with corticosteroid contraindications or complications. Prospective studies are needed to establish optimal timing and patient selection criteria for biological therapy in BP.<\/p>\n","protected":false},"template":"","class_list":["post-20878","wsa_session","type-wsa_session","status-publish","hentry","description-off"],"_links":{"self":[{"href":"https:\/\/woncaeurope2026.org\/fr\/wp-json\/wp\/v2\/wsa_session\/20878","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/woncaeurope2026.org\/fr\/wp-json\/wp\/v2\/wsa_session"}],"about":[{"href":"https:\/\/woncaeurope2026.org\/fr\/wp-json\/wp\/v2\/types\/wsa_session"}],"wp:attachment":[{"href":"https:\/\/woncaeurope2026.org\/fr\/wp-json\/wp\/v2\/media?parent=20878"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}