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Immune checkpoint inhibitor-induced Type 1 diabetes: a systematic review and meta-analysis.
Akturk, H K; Kahramangil, D; Sarwal, A; Hoffecker, L; Murad, M H; Michels, A W.
Afiliação
  • Akturk HK; Barbara Davis Centre for Diabetes, University of Colorado, School of Medicine, Aurora, CO.
  • Kahramangil D; Barbara Davis Centre for Diabetes, University of Colorado, School of Medicine, Aurora, CO.
  • Sarwal A; Department of Biology, University of Colorado, Boulder, CO.
  • Hoffecker L; Health Sciences Library, University of Colorado, Aurora, CO.
  • Murad MH; Evidence-Based Practice Centre, Mayo Clinic, Rochester, MN, USA.
  • Michels AW; Barbara Davis Centre for Diabetes, University of Colorado, School of Medicine, Aurora, CO.
Diabet Med ; 36(9): 1075-1081, 2019 09.
Article em En | MEDLINE | ID: mdl-31199005
AIM: To conduct a systematic review and meta-analysis to understand the timing and factors associated with anti-programmed cell death protein-1 (PD-1)/anti-programmed cell death protein-1 ligand (PD-L1) inhibitor-induced Type 1 diabetes. METHODS: We searched MEDLINE, EMBASE, SCOPUS and Cochrane databases (August 2000-2018) for studies of any design on immune checkpoint inhibitors. A total of 71 cases were reviewed from 56 publications. Comparisons were made using Fisher's exact and Student's t-tests. RESULTS: The mean ± sd age at Type 1 diabetes presentation was 61.7±12.2 years, 55% of cases were in men, and melanoma (53.5%) was the most frequent cancer. The median time to Type 1 diabetes onset was 49 (5-448) days with ketoacidosis in 76% of cases. The average ± sd HbA1c concentration was 62 ± 0.3 mmol/mol (7.84±1.0%) at presentation. All cases had insulin deficiency and required permanent exogenous insulin treatment. Half of the cases had Type 1 diabetes-associated antibodies at presentation, and those with antibodies had a more rapid onset (P=0.005) and higher incidence of diabetic ketoacidosis (P=0.02) compared to people without antibodies. CONCLUSIONS: Many people developed Type 1 diabetes within 3 months of initial PD-1/PD-L1 inhibitor exposure. People presenting with Type 1 diabetes-associated antibodies had a more rapid onset and higher incidence of ketoacidosis than those without antibodies. Healthcare providers caring for people receiving these state-of-the-art therapies need to be aware of this potential severe adverse event.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Diabetes Mellitus Tipo 1 / Pontos de Checagem do Ciclo Celular / Anticorpos Monoclonais Tipo de estudo: Incidence_studies / Prognostic_studies / Systematic_reviews Limite: Humans Idioma: En Revista: Diabet Med Assunto da revista: ENDOCRINOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
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XML
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Diabetes Mellitus Tipo 1 / Pontos de Checagem do Ciclo Celular / Anticorpos Monoclonais Tipo de estudo: Incidence_studies / Prognostic_studies / Systematic_reviews Limite: Humans Idioma: En Revista: Diabet Med Assunto da revista: ENDOCRINOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de publicação: Reino Unido