ArticleCancer medicine2023
Risk of diabetes mellitus among users of immune checkpoint inhibitors: A population-based cohort study.
Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Exploring risk factors for endocrine-related immune-related adverse events: Insights from meta-analysis and Mendelian randomization.Human vaccines & immunotherapeutics · 2024Pooled it
- Real-world safety of first-line enfortumab vedotin plus pembrolizumab in advanced urothelial carcinoma: evidence from VigiBase and FAERS.Frontiers in immunology · 2026Article
- Risk Factors Associated with the Development of Immune-Checkpoint Inhibitor Diabetes Mellitus: An Integrative Review.Life (Basel, Switzerland) · 2025Review
- Immune checkpoint inhibitor-induced diabetes mellitus: clinical characteristics and risk factors.Frontiers in immunology · 2025Article
- Cardiovascular adverse events associated with immune checkpoint inhibitors: A retrospective multicenter cohort study.Cancer medicine · 2024Article
- Risk of diabetes mellitus among users of immune checkpoint inhibitors: A population-based cohort study.Cancer medicine · 2023Article
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 4 countries.
Funding
Abstract
backgroundImmune 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.
methodsThis 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.
resultsAltogether, 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.
conclusionUsers 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.
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