In India Gliptins have a huge market, growing at 20% per year. I believe they are wonderful drugs. But are we neglecting something? 1. Gliptins are DPP4 inhibitors. DPP4 is present on leucocytes DPP4 is also known as adenosine deaminase binding protein (ADBP) or T-cell activation antigen CD26. DPP4 participates in adenosine deaminase binding, cell matrix adhesion, the migration and invasion of endothelial cells into collagenous matrices, co-stimulation during T cell activation. 2.
ADA is responsible for purine catabolism. Many studies have shown high ADA levels in TB, particularly in drug resistant TB 3. There is high prevalence of TB in India 4. Diabetes is a risk factor for TB 5. By using a drug which inhibits DPP4, which might cause neutropenia. Risk of TB is much more increased. Across the western world, where large RCTs for gliptins have been done, TB is not so prevalent…
