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Hepatotoxicity Associated with Immune Checkpoint Inhibitors in Clinical Practice: A Study Leveraging Data from the US Food and Drug Administration's Adverse Event Reporting System.

作者信息

Wang Haozhou, Yang Hui, Zhou Xiaoguang, Zhang Xiaodong

机构信息

Institute of Uro-nephrology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

Department of Pharmacy, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.

出版信息

Clin Ther. 2023 Feb;45(2):151-159. doi: 10.1016/j.clinthera.2023.01.001. Epub 2023 Jan 20.


DOI:10.1016/j.clinthera.2023.01.001
PMID:36682994
Abstract

PURPOSE: Immune checkpoint inhibitors (ICIs) are a promising option for the treatment of patients with various cancers. Emerging case reports have raised awareness on hepatotoxicity, a potentially fatal adverse event (AE) that may be associated with the use of ICIs. This study assessed the potential association between ICIs and hepatotoxicity through the mining of data from the US Food and Drug Administration's AE Reporting System (FAERS). METHODS: A total of 9,217,181 AEs reported in the period from quarter 1 of 2004 to quarter 3 of 2021 were assessed. Information components (ICs) and reporting odds ratios (RORs) were used to evaluate the association between the use of ICIs and hepatotoxicity. FINDINGS: A total of 52,463 AE reports listed ICIs, used alone or in combination, as a suspected drug. Of these, 1481 cases were related to both ICIs and hepatotoxicity. The use of ICIs was significantly associated with hepatotoxicity compared to all other drugs, making it a safety signal (IC = 1.43 [95% CI, 1.36-1.51]; ROR = 2.78 [95% CI, 2.64-2.93]). With monotherapy, all ICIs, except tremelimumab, were associated with liver damage. The most commonly prescribed combination therapy was nivolumab + ipilimumab (321 cases) with a significant signal detected. Notably, ICI use was significantly associated with hepatic failure (IC = 1.24 [95% CI, 1.06-1.42]; ROR = 2.40 [95% CI, 2.13-2.72]). The risk for ICI-associated hepatotoxicity (including hepatic failure) was greater with ICI combination therapy than with ICI monotherapy. All subgroups by sex and age also showed significant associations between ICI use and hepatotoxicity. IMPLICATIONS: A significant association was detected between ICI use and hepatotoxicity. The risk for hepatotoxicity (including hepatic failure) was greater with ICI combination therapy compared with ICI monotherapy.

摘要

相似文献

[1]
Hepatotoxicity Associated with Immune Checkpoint Inhibitors in Clinical Practice: A Study Leveraging Data from the US Food and Drug Administration's Adverse Event Reporting System.

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引用本文的文献

[1]
Evaluation of immune checkpoint inhibitor-associated hepatotoxic adverse events: A pharmacovigilance analysis based on the FAERS database.

Int J Immunopathol Pharmacol. 2025

[2]
Immune-related adverse events with PD-1/PD-L1 inhibitors: insights from a real-world cohort of 2523 patients.

Front Pharmacol. 2025-1-31

[3]
Drug Induced Liver Injury: Highlights and Controversies in the 2023 Literature.

Drug Saf. 2025-5

[4]
Hepatotoxicity in Cancer Immunotherapy: Diagnosis, Management, and Future Perspectives.

Cancers (Basel). 2024-12-29

[5]
Adverse events after nivolumab and ipilimumab combined immunotherapy in advanced renal cell carcinoma: a multicentre experience in Poland.

BMC Cancer. 2024-11-15

[6]
Hepatobiliary complications of immune checkpoint inhibitors in cancer.

Explor Target Antitumor Ther. 2024

[7]
The ABC of Immune-Mediated Hepatitis during Immunotherapy in Patients with Cancer: From Pathogenesis to Multidisciplinary Management.

Cancers (Basel). 2024-2-15

[8]
Severe and fatal adverse events of immune checkpoint inhibitor combination therapy in patients with metastatic renal cell carcinoma: a systematic review and meta-analysis.

Front Immunol. 2023

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