ArticleJCEM case reports2024
A Case of Enfortumab Vedotin-Associated Diabetic Ketoacidosis With Severe Insulin Resistance in a Nondiabetic Woman.
Article in JCEM case reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Targeted therapies for urothelial carcinoma: From FGFR inhibitors to next‑generation antibody-drug conjugates (Review).International journal of oncology · 2026Review
- Severe Insulin Resistance: Diagnosis and Management.Current diabetes reviews · 2026Review
- First-line treatment options for metastatic urothelial carcinoma: balancing efficacy, safety, and individual values and preferences through shared decision making.International journal of clinical oncology · 2025Review
- Risk Signals of Antibody-Drug Conjugates in Bladder Cancer: A Real-World FAERS Study.Clinical epidemiology · 2025Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Enfortumab vedotin is a novel antibody-drug conjugate (ADC) approved to treat urothelial carcinoma. One rarely reported adverse effect has been life-threatening diabetic ketoacidosis (DKA) driven by profound insulin resistance. We report a case of a 62-year-old nondiabetic woman with metastatic urothelial carcinoma who experienced DKA following her third dose of enfortumab vedotin, with extreme insulin requirements of > 1000 units daily, and full resolution of insulin requirement by day 7 of admission. Including this case, 3 of 9 reported patients with enfortumab vedotin-associated DKA have survived. Monomethyl auristatin E (MMAE), the cytotoxic component of enfortumab vedotin, is the likely cause, although the exact mechanism remains unclear. This rare clinical event challenges the usual protocols and practice surrounding insulin infusion administration, and this case provides evidence to assist in understanding the mechanism by which enfortumab vedotin causes ketoacidosis.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.