Immune checkpoint inhibitor-related type 1 diabetes incidence, risk, and survival association.

IF 3.2 3区 医学
Fumika Kamitani, Yuichi Nishioka, Miyuki Koizumi, Hiroki Nakajima, Yukako Kurematsu, Sadanori Okada, Shinichiro Kubo, Tomoya Myojin, Tatsuya Noda, Tomoaki Imamura, Yutaka Takahashi
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Abstract

Aim/introduction: Although immune checkpoint inhibitor-related type 1 diabetes mellitus (ICI-T1DM) is a rare condition, it is of significant concern globally. We aimed to elucidate the precise incidence, risk factors, and impact of ICI-T1DM on survival outcomes.

Materials and methods: The study is a large retrospective cohort study, performed using the DeSC Japanese administrative claims database comprising 11 million patients. The database population is reportedly similar to the entire population of Japan. Patients administered ICI between 2014 and 2022 were enrolled in the study, including 21,121 patients. The risk factors for ICI-T1DM development and their characteristics were evaluated by logistic regression analysis. Development of a new irAE after the day following the first administration of ICI was set as the study outcome.

Results: ICI-T1DM was observed in 102 (0.48%) of the 21,121 patients after ICI initiation. PD-(L)1 and CTLA-4 combination therapy was associated with an increased risk of ICI-T1DM compared with PD-1 monotherapy (odds ratio [OR], 2.36; 95% confidence interval [CI], 1.21-4.58; P = 0.01). Patients with a prior diagnosis of diabetes mellitus (OR, 1.59; 95% CI, 1.03-2.46; P = 0.04) or hypothyroidism (OR, 2.48; 95% CI, 1.39-4.43; P < 0.01) also exhibited an increased risk of ICI-T1DM. The Kaplan-Meier analysis revealed that patients with ICI-T1DM showed higher survival rates than those without (log-lank test, P < 0.01). Multivariable Cox regression analysis demonstrated that ICI-T1DM development was associated with lower mortality (hazard ratio, 0.60; 95% CI, 0.37-0.99; P = 0.04).

Conclusions: Collectively, the results of this study demonstrate the precise incidence and risk factors of ICI-T1DM. The development of ICI-T1DM, like other irAEs, is associated with higher survival rates.

与免疫检查点抑制剂相关的 1 型糖尿病发病率、风险和存活率关联。
目的/引言:尽管免疫检查点抑制剂相关1型糖尿病(ICI-T1DM)是一种罕见病,但它在全球范围内引起了极大关注。我们旨在阐明ICI-T1DM的确切发病率、风险因素以及对生存结果的影响:本研究是一项大型回顾性队列研究,使用的是由 1 100 万名患者组成的 DeSC 日本行政报销数据库。据报道,该数据库的人口与日本全国人口相似。2014年至2022年期间接受过ICI治疗的患者被纳入研究,其中包括21121名患者。通过逻辑回归分析评估了 ICI-T1DM 发生的风险因素及其特征。研究结果显示,在首次使用 ICI 后的第二天出现新的 irAE:结果:在开始使用 ICI 后的 21121 例患者中,有 102 例(0.48%)观察到 ICI-T1DM。与PD-1单药治疗相比,PD-(L)1和CTLA-4联合治疗与ICI-T1DM风险增加有关(几率比[OR],2.36;95%置信区间[CI],1.21-4.58;P = 0.01)。既往诊断为糖尿病(OR,1.59;95% CI,1.03-2.46;P = 0.04)或甲状腺功能减退症(OR,2.48;95% CI,1.39-4.43;P 结论:PD-1单药治疗与PD-1免疫治疗相比,疗效更佳:总之,本研究结果显示了 ICI-T1DM 的确切发病率和风险因素。与其他irAEs一样,ICI-T1DM的发生与较高的存活率相关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Diabetes Investigation
Journal of Diabetes Investigation Medicine-Internal Medicine
自引率
9.40%
发文量
218
期刊介绍: Journal of Diabetes Investigation is your core diabetes journal from Asia; the official journal of the Asian Association for the Study of Diabetes (AASD). The journal publishes original research, country reports, commentaries, reviews, mini-reviews, case reports, letters, as well as editorials and news. Embracing clinical and experimental research in diabetes and related areas, the Journal of Diabetes Investigation includes aspects of prevention, treatment, as well as molecular aspects and pathophysiology. Translational research focused on the exchange of ideas between clinicians and researchers is also welcome. Journal of Diabetes Investigation is indexed by Science Citation Index Expanded (SCIE).
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