학술논문
Shorter versus longer corticosteroid duration and recurrent immune checkpoint inhibitor-associated AKI
Document Type
article
Author
Joe-Elie Salem; Enriqueta Felip; Shuchi Anand; Karolina Benesova; Marlies Ostermann; Ala Abudayyeh; Omar Mamlouk; Umut Selamet; Grace Cherry; Sunandana Chandra; Sandra M Herrmann; Maria Jose Soler; Abhijat Kitchlu; Jamie S Lin; Kerry L Reynolds; Elizabeth M Gaughan; Eva Muñoz-Couselo; Jamie S Hirsch; Pablo Garcia; Meghan E Sise; Thibaud Koessler; Mark Eijgelsheim; Shruti Gupta; Frank B Cortazar; Jason M Prosek; Ilya Glezerman; Shveta S Motwani; Naoka Murakami; Rimda Wanchoo; David I Ortiz-Melo; Arash Rashidi; Ben Sprangers; Vikram Aggarwal; A Bilal Malik; Sebastian Loew; Christopher A Carlos; Pazit Beckerman; Zain Mithani; Chintan V Shah; Amanda D Renaghan; Sophie De Seigneux; Luca Campedel; Daniel Sanghoon Shin; Sunil Rangarajan; Priya Deshpande; Gaia Coppock; Marium Husain; Clara Garcia-Carro; Sheila Bermejo; Nuttha Lumlertgul; Nina Seylanova; Busra Isik; Aydin Kaghazchi; Yuriy Khanin; Sheru K Kansal; Kai M Schmidt-Ott; Raymond K Hsu; Maria C Tio; Harkarandeep Singh; Kenar D Jhaveri; David E Leaf; Corinne Isnard Bagnis; Suraj S Mothi; Weiting Chang; Vipulbhai Sakhiya; Daniel Stalbow; Sylvia Wu; Armando Cennamo; Anne Rigg; Nisha Shaunak; Zoe A Kibbelaar; Harish S Seethapathy; Meghan Lee; Ian A Strohbhen; Ilya G Glezerman; Dwight H Owen; Sharon Mini; Andrey Kisel; Nicole Albert; Katherine Carter; Vicki Donley; Tricia Young; Heather Cigoi; Els Wauters Ben Sprangers; Javier A Pagan; Jonathan J Hogan; Valda Page; Samuel AP Short; Maria Josep Carreras; Sethu M. Madhavan
Source
Journal for ImmunoTherapy of Cancer, Vol 10, Iss 9 (2022)
Subject
Language
English
ISSN
2051-1426
Abstract
Background Corticosteroids are the mainstay of treatment for immune checkpoint inhibitor-associated acute kidney injury (ICPi-AKI), but the optimal duration of therapy has not been established. Prolonged use of corticosteroids can cause numerous adverse effects and may decrease progression-free survival among patients treated with ICPis. We sought to determine whether a shorter duration of corticosteroids was equally efficacious and safe as compared with a longer duration.Methods We used data from an international multicenter cohort study of patients diagnosed with ICPi-AKI from 29 centers across nine countries. We examined whether a shorter duration of corticosteroids (28 days or less) was associated with a higher rate of recurrent ICPi-AKI or death within 30 days following completion of corticosteroid treatment as compared with a longer duration (29–84 days).Results Of 165 patients treated with corticosteroids, 56 (34%) received a shorter duration of treatment and 109 (66%) received a longer duration. Patients in the shorter versus longer duration groups were similar with respect to baseline and ICPi-AKI characteristics. Five of 56 patients (8.9%) in the shorter duration group and 12 of 109 (11%) in the longer duration group developed recurrent ICPi-AKI or died (p=0.90). Nadir serum creatinine in the first 14, 28, and 90 days following completion of corticosteroid treatment was similar between groups (p=0.40, p=0.56, and p=0.89, respectively).Conclusion A shorter duration of corticosteroids (28 days or less) may be safe for patients with ICPi-AKI. However, the findings may be susceptible to unmeasured confounding and further research from randomized clinical trials is needed.