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Diabetes and Blood Glucose Disorders Under Anti-PD1
Open accessAbstract
Acute type 1 diabetes (AD1) is a rare but definitive immune-related adverse event associated with anti-PD1. Most of the reported cases are close to what has been described as “fulminant type 1 diabetes.” We sought to determine whether anti-PD1 could impair glycoregulation and whether occurrence of AD1 could be anticipated by prior glycemic changes. Fasting glycemia collected before, under, and after treatment in melanoma patients treated with anti-PD1 over a period of 36 months were retrospectively analyzed. Glycemic trend analyses were performed using linear regression analysis. In total, 1470 glucose values were monitored in 163 patients treated for a mean duration of 5.96 months. Three patients developed an AD1 (1, 84%). Two other cases were observed in the same period in a still-blinded trial of anti-PD1 versus ipilimumab. All cases of AD1 occurred in patients with a normal pretreatment glycemia, and there was no detectable drift of glycemia before ketoacidosis onset. In 4 of 5 cases of AD1, the HLA subgroups were DRB01* 03 or 04, known to increase type 1 diabetes risk in the general population. In the 28 patients with preexisting type 2 diabetes, there was a slight trend for glycemia increase with anti-PD1 infusions (0.05 mmol/L/infusion P=0.004). In the 132 patients with normal pretreatment glycemia, there was a slight trend for a decrease of glycemia with anti-PD1 infusions (−0.012/mmol/L/infusion P=0.026). These data suggest that the monitoring of glycemia under anti-PD1 cannot help to anticipate AD1, and there is no general tendency to glycemic disorder. HLA genotyping before treatment may help to focus surveillance in patients with the HLA DRB1*03/04 group.
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“There is a significant knowledge gap regarding the impact of pharmacologic treatments for DM on gamete health, fertility, and pregnancy as well as for reproductive technologies.1565”
From American Association of Clinical Endocrinology Clinical Practice Guideline: Developing a Diabetes Mellitus Comprehensive Care Plan-2022 Update. (2022) · cites this paper as [1565]
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Blonde, L., Umpierrez, G. E., Reddy, S. S., McGill, J. B., Berga, S. L., Bush, M., Chandrasekaran, S., DeFronzo, R. A., Einhorn, D., Galindo, R. J., et al. (2022) · Endocrine Practice · doi:10.1016/j.eprac.2022.08.002 · Cited by 507
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Metadata
- Authors
- Magis, Q., Gaudy-Marqueste, C., Basire, A., Loundou, A., Malissen, N., Troin, L., Monestier, S., Mallet, S., Hesse, S., Richard, M.-A., Valéro, R., Beliard, S., & Grob, J.-J.
- Affiliations
- Aix-Marseille Université (FR)
- Dermatology and Skin Cancer Department, Aix-Marseille University, Hôpital de la Timone
- Immunogenetics laboratory, EFS-Alpes Méditerranée, Marseille, France
- Endocrinology Department, Aix-Marseille University, Hôpital de la Conception
- Corresponding author
- Magis, Quentin
- Malissen, Nausicaa
- Troin, Laura
- Monestier, Sandrine
- Mallet, Stéphanie
- Hesse, Sylvie
- Richard, Marie-Aleth
- Grob, Jean-Jacques
- ORCID
- Venue
- Journal of Immunotherapy
- Published
- 2018-06
- Volume
- 41
- Issue
- 5
- Pages
- 232-240
- ISSN
- 1524-9557 (ISSN-L)
- OpenAlex
- W2789846344
- Cited by
- 39
- References
- 40
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 7 · 2022: 7 · 2021: 4 · 2020: 7 · 2019: 3 · 2018: 4
- FWCI
- 1.70
- Type
- journal article
- Language
- en
- Open access
- green
- amu.hal.science
- Licence
- other-oa
- Locations
- Journal of Immunotherapy (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Oncology › Cancer Immunotherapy and Biomarkers
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- anti-PD-1 therapy, immune-related adverse events, melanoma, fasting blood glucose, HLA typing, ipilimumab, ketoacidosis, immune checkpoint inhibitors
- MeSH terms
- Glycemic Load, Ipilimumab, Nivolumab, Acute Disease, Adult, Aged, Aged, 80 and over, Blood Glucose, Diabetes Mellitus, Type 1, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Single-Cell Analysis, HLA-DRB1 Chains, Programmed Cell Death 1 Receptor, Antibodies, Monoclonal, Humanized, Drug-Related Side Effects and Adverse Reactions
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