Table 1.
Clinical, metabolic and immunological characteristics of anti‐programmed cell death protein‐1 or anti‐programmed cell death protein‐1 ligand inhibitor‐induced Type 1 diabetes
| All cases (n=71) | Nivolumab (n=38) | Pembrolizumab (n=26) | anti‐PD‐L1a (n=7) | |
|---|---|---|---|---|
| Age, years | ||||
| Mean (sd) | 61.7 (12.2) | 61.4 (12.8) | 61.1 (11.4) | 65.7 (10.8) |
| Median | 62.0 | 62.5 | 61.0 | 66.5 |
| Range | 23–84 | 28–83 | 23–82 | 50–84 |
| Gender | ||||
| Female, % | 45.0 | 50.0 | 38.5 | 42.8 |
| Cancer type, % ( n) | ||||
| Melanoma | 53.5 (38) | 50.0 (19) | 73.0 (19) | 0 (0) |
| Lung | 26.8 (19) | 34.2 (13) | 15.4 (4) | 28.5 (2) |
| Renal cell | 5.7 (4) | 10.6 (4) | 0 (0) | 0 (0) |
| Head and neck | 7.0 (5) | 2.6 (1) | 7.7 (2) | 28.5 (2) |
| Urothelial carcinoma | 4.2 (3) | 0 (0) | 0 (0) | 43.0 (3) |
| Other | 2.8 (2) | 2.6 (1) | 3.9 (1) | 0 (0) |
| Duration to diabetes, days | ||||
| Mean (sd) | 83.5 (88.5) | 98.0 (102.1) | 65.9 (72.1) | 75.0 (39.7) |
| Median | 49 | 73.5 | 42 | 84 |
| Range | 5‐448 | 5‐448 | 14‐365 | 21‐126 |
| Diabetic ketoacidosis, % ( n) | ||||
| Present | 76.0 (54) | 71.0 (27) | 80.7 (21) | 85.7 (6) |
| Severe | 38.9 (21) | 33.3 (9) | 52.4 (11) | 16.6 (1) |
| Moderate | 20.4 (11) | 22.2 (6) | 14.3 (3) | 33.3 (2) |
| Mild | 11.1 (6) | 3.7 (1) | 14.3 (3) | 33.3 (2) |
| Not able to assess | 29.6 (16) | 40.8 (11) | 19.0 (4) | 16.6 (1) |
| Blood glucose, mmol/l | ||||
| Mean (sd) | 33.4 (11.5) | 33.8 (12.1) | 34.1 (9.5) | 29.4 (13.8) |
| Median | 32.2 | 31.7 | 34.2 | 22.8 |
| Range | 13.7–67.3 | 13.7–67.3 | 15.0–50.5 | 18.1–56.4 |
| HbA 1c , mmol/mol | ||||
| Mean (sd) | 62 (0.3) | 60 (0.3) | 64 (0.3) | 66 (0.4) |
| Median | 61 | 56 | 62 | 66 |
| Range | 40–93 | 40–88 | 40–93 | 46–84 |
| Type 1 diabetes‐associated antibodies, % ( n) | ||||
| Present | 50.7 (36) | 44.7 (17) | 57.7 (15) | 57.1 (4) |
| Absent | 49.3 (35) | 55.3 (21) | 42.3 (11) | 42.9 (3) |
| Type 1 diabetes risk HLA genes b , % ( n) | ||||
| Present | 38.0 (27) | 39.5 (15) | 38.5 (10) | 28.5 (2) |
| Absent | 7.0 (5) | 13.1 (5) | 0 (0) | 0 (0) |
| Not Reported | 55.0 (39) | 47.4 (18) | 61.5 (16) | 71.5 (5) |
| Ipilimumab (anti‐CTLA‐4) use c , % ( n) | ||||
| Present | 31.0 (22) | 31.5 (12) | 38.5 (10) | 0 (0) |
| Absent | 69.0 (49) | 68.5 (26) | 61.5 (16) | 100.0 (7) |
HLA, human leukocyte antigen; PD‐1, programmed cell death protein; PD‐L1, programmed cell death protein‐1 ligand.
a
Atezolizumab, avelumab and durvalumab.
b
HLA‐DQ‐DR risk genes include DR3, DR4, DQ2, DQ8.
c
Prior or concurrent use of ipilimumab with anti‐PD‐1/PD‐L1 treatment.