Despite scattered case reports suggesting an association, quantitative population-based evidence remains sparse.2, 3, 4 To address this gap, we leveraged the global federated health research network TriNetX to investigate the incident risk of pemphigus in patients treated with PD-1, PD-1L, or CTLA-4 inhibitors compared to a control group using electronic medical record data from over 120 million patients worldwide. The gene discussed is CTLA4; the disease is pemphigus.