Immune checkpoint inhibitor‐related type 1 diabetes incidence, risk, and survival association
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 stu...
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| Format: | Article |
| Language: | English |
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Wiley
2025-02-01
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| Series: | Journal of Diabetes Investigation |
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| Online Access: | https://doi.org/10.1111/jdi.14362 |
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| author | Fumika Kamitani Yuichi Nishioka Miyuki Koizumi Hiroki Nakajima Yukako Kurematsu Sadanori Okada Shinichiro Kubo Tomoya Myojin Tatsuya Noda Tomoaki Imamura Yutaka Takahashi |
| author_facet | Fumika Kamitani Yuichi Nishioka Miyuki Koizumi Hiroki Nakajima Yukako Kurematsu Sadanori Okada Shinichiro Kubo Tomoya Myojin Tatsuya Noda Tomoaki Imamura Yutaka Takahashi |
| author_sort | Fumika Kamitani |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-178d7d8c85d64800b0d733eb0cd2f966 |
| institution | Kabale University |
| issn | 2040-1116 2040-1124 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Diabetes Investigation |
| spelling | doaj-art-178d7d8c85d64800b0d733eb0cd2f9662025-02-01T10:02:01ZengWileyJournal of Diabetes Investigation2040-11162040-11242025-02-0116233434210.1111/jdi.14362Immune checkpoint inhibitor‐related type 1 diabetes incidence, risk, and survival associationFumika Kamitani0Yuichi Nishioka1Miyuki Koizumi2Hiroki Nakajima3Yukako Kurematsu4Sadanori Okada5Shinichiro Kubo6Tomoya Myojin7Tatsuya Noda8Tomoaki Imamura9Yutaka Takahashi10Department of Diabetes and Endocrinology Nara Medical University Kashihara Nara JapanDepartment of Public Health, Health Management and Policy Nara Medical University Kashihara Nara JapanDepartment of Diabetes and Endocrinology Nara Medical University Kashihara Nara JapanDepartment of Diabetes and Endocrinology Nara Medical University Kashihara Nara JapanDepartment of Diabetes and Endocrinology Nara Medical University Kashihara Nara JapanDepartment of Diabetes and Endocrinology Nara Medical University Kashihara Nara JapanDepartment of Public Health, Health Management and Policy Nara Medical University Kashihara Nara JapanDepartment of Public Health, Health Management and Policy Nara Medical University Kashihara Nara JapanDepartment of Public Health, Health Management and Policy Nara Medical University Kashihara Nara JapanDepartment of Public Health, Health Management and Policy Nara Medical University Kashihara Nara JapanDepartment of Diabetes and Endocrinology Nara Medical University Kashihara Nara JapanABSTRACT 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.https://doi.org/10.1111/jdi.14362Immune checkpoint inhibitorsSurvivalType 1 diabetes mellitus |
| spellingShingle | Fumika Kamitani Yuichi Nishioka Miyuki Koizumi Hiroki Nakajima Yukako Kurematsu Sadanori Okada Shinichiro Kubo Tomoya Myojin Tatsuya Noda Tomoaki Imamura Yutaka Takahashi Immune checkpoint inhibitor‐related type 1 diabetes incidence, risk, and survival association Journal of Diabetes Investigation Immune checkpoint inhibitors Survival Type 1 diabetes mellitus |
| title | Immune checkpoint inhibitor‐related type 1 diabetes incidence, risk, and survival association |
| title_full | Immune checkpoint inhibitor‐related type 1 diabetes incidence, risk, and survival association |
| title_fullStr | Immune checkpoint inhibitor‐related type 1 diabetes incidence, risk, and survival association |
| title_full_unstemmed | Immune checkpoint inhibitor‐related type 1 diabetes incidence, risk, and survival association |
| title_short | Immune checkpoint inhibitor‐related type 1 diabetes incidence, risk, and survival association |
| title_sort | immune checkpoint inhibitor related type 1 diabetes incidence risk and survival association |
| topic | Immune checkpoint inhibitors Survival Type 1 diabetes mellitus |
| url | https://doi.org/10.1111/jdi.14362 |
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