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DPP-4 inhibitor (sitagliptin)-induced seronegative rheumatoid arthritis
  1. Simonette Padron1,
  2. Everett Rogers1,
  3. Michelle Demory Beckler2 and
  4. Marc Kesselman3
  1. 1 Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, Florida, USA
  2. 2 Department of Microbiology, Nova Southeastern University Health Professions Division, College of Medical Sciences, Fort Lauderdale, Florida, USA
  3. 3 Division of Rheumatology, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, Florida, USA
  1. Correspondence to Dr Marc Kesselman, mkesselman{at}


Sitagliptin is a dipeptidyl peptidase-4 inhibitor commonly used in the treatment of type 2 diabetes mellitus for glycaemic control. Concerns have arisen regarding adverse events caused by this drug, particularly concerning arthralgias. Here, we report on a 56-year-old man being treated with sitagliptin who developed inflammatory arthritis after taking the drug for 6 months. The patient presented with pain, swelling and erythema in multiple joints and was eventually diagnosed with seronegative rheumatoid arthritis (RA) under the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria. His symptoms continued for several months after stopping sitagliptin and eventually went into remission after a tapered course of steroids, hydroxychloroquine and methotrexate. Furthermore, the patient is HLA-DRB3 positive, a genetic marker that is still being investigated for its role in the pathogenesis of RA and that may have been a predisposing factor in the development of this patient’s inflammatory arthropathy.

  • musculoskeletal and joint disorders
  • drugs: endocrine system
  • immunology
  • unwanted effects/adverse reactions
  • rheumatoid arthritis
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  • Contributors Supervised by MK. Patient was under the care of MK. Report was written by SP and ER and was edited by MDB.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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