Clinical Features of Liver Injury Induced by Immune Checkpoint Inhibitors in Japanese Patients
Joint Authors
Ogawa, Yoshihiro
Imoto, Koji
Kohjima, Motoyuki
Hioki, Tomonobu
Kurashige, Tomoyuki
Kurokawa, Miho
Tashiro, Shigeki
Suzuki, Hideo
Kuwano, Akifumi
Tanaka, Masatake
Okada, Seiji
Kato, Masaki
Source
Canadian Journal of Gastroenterology and Hepatology
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-12, 12 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-12-18
Country of Publication
Egypt
No. of Pages
12
Main Subjects
Abstract EN
Aim.
Immune checkpoint inhibitors (ICIs) have improved the survival rate of patients carrying various malignant neoplasms.
Despite their efficacy, ICIs occasionally induce liver injury as an immune-related adverse event (irAE).
This study aimed to reveal the clinical features of the hepatic irAE in Japanese patients.
Methods.
Among 387 patients treated with ICIs, those who developed drug-induced liver injury were investigated.
We also describe the histological findings and clinical courses of four patients with hepatic irAE who underwent liver biopsy.
Results.
Among the 56 patients with all-grade liver injury, only 11 (19.6%) showed hepatocellular-type liver injury, which resembled autoimmune hepatitis.
Thirty-four patients (60.7%) developed cholestatic or mixed-type liver injury, although only one patient showed abnormal image findings in the bile duct.
Most patients with grade ≤2 liver injury improved spontaneously, while two patients with biliary dysfunction required ursodeoxycholic acid or prednisolone.
Among eight patients with grade ≥3 liver injury, three required no immunosuppressants and five were treated with prednisolone (three of five patients required other types of immunosuppressants).
Four patients in the case series showed diverse clinical features in terms of hepatotoxic pattern, symptoms, and the interval time between the initiation of immunotherapy and the onset of the hepatic irAE.
Conclusions.
Our findings suggest that ICIs could cause microscopic biliary disorder without any abnormal image finding.
Because the hepatic irAE presents diverse clinical features, liver biopsy is recommended to provide appropriate treatments.
American Psychological Association (APA)
Imoto, Koji& Kohjima, Motoyuki& Hioki, Tomonobu& Kurashige, Tomoyuki& Kurokawa, Miho& Tashiro, Shigeki…[et al.]. 2019. Clinical Features of Liver Injury Induced by Immune Checkpoint Inhibitors in Japanese Patients. Canadian Journal of Gastroenterology and Hepatology،Vol. 2019, no. 2019, pp.1-12.
https://search.emarefa.net/detail/BIM-1129888
Modern Language Association (MLA)
Imoto, Koji…[et al.]. Clinical Features of Liver Injury Induced by Immune Checkpoint Inhibitors in Japanese Patients. Canadian Journal of Gastroenterology and Hepatology No. 2019 (2019), pp.1-12.
https://search.emarefa.net/detail/BIM-1129888
American Medical Association (AMA)
Imoto, Koji& Kohjima, Motoyuki& Hioki, Tomonobu& Kurashige, Tomoyuki& Kurokawa, Miho& Tashiro, Shigeki…[et al.]. Clinical Features of Liver Injury Induced by Immune Checkpoint Inhibitors in Japanese Patients. Canadian Journal of Gastroenterology and Hepatology. 2019. Vol. 2019, no. 2019, pp.1-12.
https://search.emarefa.net/detail/BIM-1129888
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1129888