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Risk of diabetes mellitus among users of immune checkpoint inhibitors: A population‐based cohort study
BACKGROUND: Immune checkpoint inhibitors (ICIs) are increasingly established cancer therapeutics, but they are associated with new‐onset diabetes mellitus (DM). Such risks have not been adequately quantified, and between‐class and ‐sex differences remain unexplored. METHODS: This was a prospective c...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134274/ https://www.ncbi.nlm.nih.gov/pubmed/36647331 http://dx.doi.org/10.1002/cam4.5616 |
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author | Chan, Jeffrey Shi Kai Lee, Sharen Kong, Dicken Lakhani, Ishan Ng, Kenrick Dee, Edward Christopher Tang, Pias Lee, Yan Hiu Athena Satti, Danish Iltaf Wong, Wing Tak Liu, Tong Tse, Gary |
author_facet | Chan, Jeffrey Shi Kai Lee, Sharen Kong, Dicken Lakhani, Ishan Ng, Kenrick Dee, Edward Christopher Tang, Pias Lee, Yan Hiu Athena Satti, Danish Iltaf Wong, Wing Tak Liu, Tong Tse, Gary |
author_sort | Chan, Jeffrey Shi Kai |
collection | PubMed |
description | BACKGROUND: Immune checkpoint inhibitors (ICIs) are increasingly established cancer therapeutics, but they are associated with new‐onset diabetes mellitus (DM). Such risks have not been adequately quantified, and between‐class and ‐sex differences remain unexplored. METHODS: This was a prospective cohort study of cancer patients receiving any ICI in Hong Kong between 2013 and 2021. Patients with known DM were excluded. Due to few patients using other ICIs, only programmed cell death 1 inhibitors (PD‐1i) and programmed death ligand 1 inhibitors (PD‐L1i) were compared, alongside between‐sex comparison. When comparing PD‐1i against PD‐L1i, patients with the use of other ICIs or both PD‐1i and PD‐L1 were further excluded. Inverse probability treatment weighting (IPTW) was used to minimize between‐group covariate imbalances. RESULTS: Altogether, 3375 patients were analyzed (65.2% males, median age 62.2 [interquartile range 53.8–69.5] years old). Over a median follow‐up of 1.0 [0.4–2.4] years, new‐onset DM occurred in 457 patients (13.5%), with a 3‐year risk of 14.5% [95% confidence interval 13.3%, 15.8%]. IPTW achieve acceptable covariate balance between sexes, and between PD‐1i (N = 622) and PD‐L1i (N = 2426) users. Males had significantly higher risk of new‐onset DM (hazard ratio 1.35 [1.09, 1.67], p = 0.006), while PD‐1i and PD‐L1i users did not have significantly different risks (hazard ratio vs PD‐L1i 0.81 [0.59, 1.11], p = 0.182). These were consistent in those with at least 1 year of follow‐up, and on competing risk regression. CONCLUSION: Users of ICI may have a substantial risk of new‐onset DM, which may be higher in males but did not differ between PD‐1i and PD‐L1i. |
format | Online Article Text |
id | pubmed-10134274 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-101342742023-04-28 Risk of diabetes mellitus among users of immune checkpoint inhibitors: A population‐based cohort study Chan, Jeffrey Shi Kai Lee, Sharen Kong, Dicken Lakhani, Ishan Ng, Kenrick Dee, Edward Christopher Tang, Pias Lee, Yan Hiu Athena Satti, Danish Iltaf Wong, Wing Tak Liu, Tong Tse, Gary Cancer Med RESEARCH ARTICLES BACKGROUND: Immune checkpoint inhibitors (ICIs) are increasingly established cancer therapeutics, but they are associated with new‐onset diabetes mellitus (DM). Such risks have not been adequately quantified, and between‐class and ‐sex differences remain unexplored. METHODS: This was a prospective cohort study of cancer patients receiving any ICI in Hong Kong between 2013 and 2021. Patients with known DM were excluded. Due to few patients using other ICIs, only programmed cell death 1 inhibitors (PD‐1i) and programmed death ligand 1 inhibitors (PD‐L1i) were compared, alongside between‐sex comparison. When comparing PD‐1i against PD‐L1i, patients with the use of other ICIs or both PD‐1i and PD‐L1 were further excluded. Inverse probability treatment weighting (IPTW) was used to minimize between‐group covariate imbalances. RESULTS: Altogether, 3375 patients were analyzed (65.2% males, median age 62.2 [interquartile range 53.8–69.5] years old). Over a median follow‐up of 1.0 [0.4–2.4] years, new‐onset DM occurred in 457 patients (13.5%), with a 3‐year risk of 14.5% [95% confidence interval 13.3%, 15.8%]. IPTW achieve acceptable covariate balance between sexes, and between PD‐1i (N = 622) and PD‐L1i (N = 2426) users. Males had significantly higher risk of new‐onset DM (hazard ratio 1.35 [1.09, 1.67], p = 0.006), while PD‐1i and PD‐L1i users did not have significantly different risks (hazard ratio vs PD‐L1i 0.81 [0.59, 1.11], p = 0.182). These were consistent in those with at least 1 year of follow‐up, and on competing risk regression. CONCLUSION: Users of ICI may have a substantial risk of new‐onset DM, which may be higher in males but did not differ between PD‐1i and PD‐L1i. John Wiley and Sons Inc. 2023-01-16 /pmc/articles/PMC10134274/ /pubmed/36647331 http://dx.doi.org/10.1002/cam4.5616 Text en © 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | RESEARCH ARTICLES Chan, Jeffrey Shi Kai Lee, Sharen Kong, Dicken Lakhani, Ishan Ng, Kenrick Dee, Edward Christopher Tang, Pias Lee, Yan Hiu Athena Satti, Danish Iltaf Wong, Wing Tak Liu, Tong Tse, Gary Risk of diabetes mellitus among users of immune checkpoint inhibitors: A population‐based cohort study |
title | Risk of diabetes mellitus among users of immune checkpoint inhibitors: A population‐based cohort study |
title_full | Risk of diabetes mellitus among users of immune checkpoint inhibitors: A population‐based cohort study |
title_fullStr | Risk of diabetes mellitus among users of immune checkpoint inhibitors: A population‐based cohort study |
title_full_unstemmed | Risk of diabetes mellitus among users of immune checkpoint inhibitors: A population‐based cohort study |
title_short | Risk of diabetes mellitus among users of immune checkpoint inhibitors: A population‐based cohort study |
title_sort | risk of diabetes mellitus among users of immune checkpoint inhibitors: a population‐based cohort study |
topic | RESEARCH ARTICLES |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10134274/ https://www.ncbi.nlm.nih.gov/pubmed/36647331 http://dx.doi.org/10.1002/cam4.5616 |
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