Increased Reporting of Immune Checkpoint Inhibitor-Associated Diabetes

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.