Association of co-administration of neurokinin-1 receptor antagonists and dexamethasone with new-onset diabetes in patients receiving chemotherapy: a retrospective cross-sectional study using health claims database in Japan.
5 affiliations
- 1Department of Clinical Pharmacology, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan.
- 2Department of Pharmacy, Kanagawa Prefectural Keiyukai, Keiyu Hospital, Kanagawa, Japan.
- 3Drug Informatics Group, Laboratory of Clinical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1, Horinouchi, Hachioji-City, Tokyo, 192-0392, Japan. [email protected].
- 4Drug Informatics Group, Laboratory of Clinical Pharmacy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, 1432-1, Horinouchi, Hachioji-City, Tokyo, 192-0392, Japan.
- 5Division of Pharmacoepidemiology, Showa Medical University Graduate School of Pharmacy, Tokyo, Japan.
Abstract
Purpose
We aimed to optimize antiemetic strategies by evaluating the association of co-administration of neurokinin-1 receptor antagonist (NK1-RA) administration and dexamethasone on new-onset diabetes in patients receiving chemotherapy.Methods
This retrospective cross-sectional study was conducted using the DeSC database and included patients aged ≥ 18 years with solid tumors who initiated parenteral anticancer agents and dexamethasone between April 2014 and March 2023. Patients with a history of diabetes or hematologic malignancies were excluded. The primary outcome was new-onset diabetes during the 2 months following the index month, defined by International Classification of Diseases, Tenth Revision codes or prescription data. Multivariable logistic regression assessed the association between co-administration of NK1-RA and dexamethasone and new-onset diabetes.Results
Among 71,539 eligible patients, 51.1% received NK1-RAs. Co-administration of NK1-RA and dexamethasone was significantly associated with an increased risk of new-onset diabetes (adjusted odds ratio: 1.43; 95% confidence interval: 1.31-1.55; p < 0.001). Sensitivity analyses demonstrated consistent results across different evaluation periods and outcome definitions.Conclusion
Co-administration of NK1-RA and dexamethasone was associated with an increased risk of new-onset diabetes. These findings highlight a previously unrecognized safety signal and support the careful management of dexamethasone, as recommended by many clinical guidelines.
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BibTeX
@article{ozawa2026association,
title = {{Association of co-administration of neurokinin-1 receptor antagonists and dexamethasone with new-onset diabetes in patients receiving chemotherapy: a retrospective cross-sectional study using health claims database in Japan.}},
author = {Yuki Ozawa and Shinya Suzuki and Takuma Koinuma and Takashi Yokokawa and Takenori Ichimura and Kenichi Suzuki and Yusuke Hori and Shinobu Imai},
journal = {Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer},
year = {2026},
month = oct,
doi = {10.1007/s00520-026-11414-2},
url = {https://europepmc.org/article/MED/42955428},
note = {CC BY},
}
RIS
TY - JOUR
TI - Association of co-administration of neurokinin-1 receptor antagonists and dexamethasone with new-onset diabetes in patients receiving chemotherapy: a retrospective cross-sectional study using health claims database in Japan.
AU - Yuki Ozawa
AU - Shinya Suzuki
AU - Takuma Koinuma
AU - Takashi Yokokawa
AU - Takenori Ichimura
AU - Kenichi Suzuki
AU - Yusuke Hori
AU - Shinobu Imai
PY - 2026
DA - 2026/10/29
JO - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
DO - 10.1007/s00520-026-11414-2
UR - https://europepmc.org/article/MED/42955428
AB - Purpose We aimed to optimize antiemetic strategies by evaluating the association of co-administration of neurokinin-1 receptor antagonist (NK1-RA) administration and dexamethasone on new-onset diabetes in patients receiving chemotherapy.Methods This retrospective cross-sectional study was conducted using the DeSC database and included patients aged ≥ 18 years with solid tumors who initiated parenteral anticancer agents and dexamethasone between April 2014 and March 2023. Patients with a history of diabetes or hematologic malignancies were excluded. The primary outcome was new-onset diabetes during the 2 months following the index month, defined by International Classification of Diseases, Tenth Revision codes or prescription data. Multivariable logistic regression assessed the association between co-administration of NK1-RA and dexamethasone and new-onset diabetes.Results Among 71,539 eligible patients, 51.1% received NK1-RAs. Co-administration of NK1-RA and dexamethasone was significantly associated with an increased risk of new-onset diabetes (adjusted odds ratio: 1.43; 95% confidence interval: 1.31-1.55; p < 0.001). Sensitivity analyses demonstrated consistent results across different evaluation periods and outcome definitions.Conclusion Co-administration of NK1-RA and dexamethasone was associated with an increased risk of new-onset diabetes. These findings highlight a previously unrecognized safety signal and support the careful management of dexamethasone, as recommended by many clinical guidelines.
SN - 0941-4355
SN - 1433-7339
ER -