Immune-mediated liver injury induced by PD-1/PD-L1 inhibitors differs from idiosyncratic drug-induced liver injury - 13/10/26
, Yan Wang 1, ⁎, ⁎ , Xinyan Zhao 1, ⁎, ⁎ Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder
Highlights |
• | ILICI tended to show longer latency than iDILI. |
• | ILICI was more often characterized by cholestatic or mixed liver injury. |
• | Hepatic inflammation on imaging was less frequent in ILICI than iDILI. |
• | Liver histology in ILICI was characterized mainly by cholestatic features. |
• | ILICI with hepatocellular injury pattern showed faster ALT normalization than iDILI. |
Abstract |
Aim |
This study aimed to compare the clinical characteristics, pathology, and outcomes of ILICI and iDILI.
Methods |
In this single-center retrospective study, clinical, laboratory, imaging, pathological, and outcome data from patients diagnosed with ILICI or iDILI were analyzed.
Results |
A total of 71 ILICI and 305 iDILI cases were included. Compared with the iDILI cohort, patients with ILICI were older (median age 66.0 vs. 56.0 years, P < 0.001). The ILICI group exhibited longer latency, a higher proportion of cholestatic and mixed liver injury patterns, and less severe biochemical abnormalities, with lower ALT, AST, and total bilirubin levels ( P < 0.001). Imaging revealed less frequent signs of hepatic inflammation in ILICI ( P < 0.05). Histologically, ILICI appeared to be associated with cholestatic features. Among patients with hepatocellular injury pattern, the cumulative rate of ALT normalization was significantly higher in the ILICI group (HR: 3.677, P < 0.001).
Conclusions |
Our study revealed that, compared with patients with iDILI, the patients with ILICI may present with a higher proportion of the cholestatic biochemical pattern. Furthermore, hepatocellular ILICI showed a trend toward more rapid biochemical recovery compared with hepatocellular iDILI.
Le texte complet de cet article est disponible en PDF.Keywords : PD-1/PD-L1 checkpoint inhibitors, idiosyncratic drug-induced liver injury, clinical characteristics, outcomes
Abbreviation : ALT, ALP, AST, CMV, CTCAE, CTLA-4, EBV, GGT, HR, ICIs, iDILI, ILICI, INR, irAEs, PD-1, PD-L1, RUCAM, TACE, TBIL, ULN
Plan
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