■ 学会名
ENDO2025

■ 発表日
2025/07/12-15

■ 筆頭演者
Fumika Kamitani¹,²
1) Department of Diabetes and Endocrinology, Nara Medical University, Kashihara, Japan.
2) Department of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Japan.

■ 共同演者
Yuichi Nishioka¹,², Hiroki Nakajima¹, Yukako Kurematsu¹, Sadanori Okada¹, Tomoya Myojin², Tatsuya Noda², Tomoaki Imamura², Yutaka Takahashi¹.
1) Department of Diabetes and Endocrinology, Nara Medical University, Kashihara, Japan.
2) Department of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Japan.

■ 発表形態
Poster

■ 要旨
Objective: To clarify the incidence and effect of multiple endocrine abnormalities on the overall survival (OS) in patients treated with immune checkpoint inhibitor (ICI).
Methods: We analyzed 12,978 patients treated with ICI using a Japanese administrative claims database including 12.4 million patients. Endocrine abnormalities were defined by hormone replacement therapy or insulin administration and a specific self-injection fee for T1DM. Kaplan–Meier analysis and Cox regression analysis adjusting for the number of ICI administrations and duration were performed to assess the effect of endocrine abnormalities on OS.
Results: Hypothyroidism, adrenal insufficiency, and T1DM were observed in 10.5%, 4.6%, and 0.6% of patients, respectively. Multiple endocrine abnormalities were observed in 1.4%, and the most common combination was hypothyroidism and adrenal insufficiency (1.3%). Among 12,978 patients treated with ICIs, 4,738 patients (36.5%) died during the observation period. The development of adrenal insufficiency and hypothyroidism was associated with lower mortality than none (adjusted hazard ratio [aHR] 0.60 and 0.65, respectively). Kaplan–Meier analysis showed better survival in patients with single and multiple endocrine abnormalities than in those without them (P < .01). Multivariable analysis also showed lower mortality in patients with single and multiple endocrine abnormalities groups (aHR 0.65; 95%CI, 0.58-0.72, P < .01; aHR 0.39; 95% CI, 0.28-0.54, P < .01, respectively) than in those without them. In addition, mortality was significantly lower in patients with multiple group than in single group (aHR 0.56; 95% CI, 0.39-0.79, P < .01). Conclusion: The development of multiple endocrine abnormalities was associated with superior survival compared with that of a single abnormality in patients treated with ICI.