Increased Reporting of Immune Checkpoint Inhibitor-Associated Diabetes

• Published in: Diabetes care Vol. 41; no. 12; pp. e150 - e151
• Main Authors: Wright, Jordan J, Salem, Joe-Elie, Johnson, Douglas B, Lebrun-Vignes, Bénédicte, Stamatouli, Angeliki, Thomas, James W, Herold, Kevan C, Moslehi, Javid, Powers, Alvin C
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01-12-2018
• Subjects: Cancer; Cancer therapies; Diabetes; Diabetes mellitus; Diabetes mellitus (insulin dependent); e-Letters: Comments and Responses; Immune system; Immunomodulation; Inhibitors; Insulin; Ketoacidosis; Life Sciences; Medical treatment; Risk factors; Side effects; Steroid hormones; Steroids
• ISSN: 0149-5992; 1935-5548; 0149-5992
• DOI: 10.2337/dc18-1465

Wright et al. discuss the increased reporting of immune checkpoint inhibitor (CPI)-associated diabetes. They analyzed VigiBase, the World Health Organization's database of individual case safety reports, and detected 283 cases of new-onset DM from 2014 to April 2018 following treatment with CPI using the following preferred terms according to MedDRA (Medical Dictionary for Regulatory Activities): diabetic ketoacidosis (DKA), diabetic ketosis, type 1 diabetes mellitus, or fulminant type 1 diabetes mellitus; any one of these was sufficient to define CPI-DM. They noted a marked increase in reporting of CPI-DM over this time period, with over 50% of cases reported in 2017. Overall, half of the patients with DM presented in DKA (50.2%); 5.6% of all cases were also on steroids at diagnosis of DM, and 6.4% were on noninsulin diabetes medications in addition to insulin. Prior and/or subsequent cancer therapies are unknown, but no other immunomodulatory medications were reported.