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Shorter versus longer corticosteroid duration and recurrent immune checkpoint inhibitor-associated AKI
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 sur...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9511654/ https://www.ncbi.nlm.nih.gov/pubmed/36137651 http://dx.doi.org/10.1136/jitc-2022-005646 |
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author | Gupta, Shruti Garcia-Carro, Clara Prosek, Jason M Glezerman, Ilya Herrmann, Sandra M Garcia, Pablo Abudayyeh, Ala Lumlertgul, Nuttha Malik, A Bilal Loew, Sebastian Beckerman, Pazit Renaghan, Amanda D Carlos, Christopher A Rashidi, Arash Mithani, Zain Deshpande, Priya Rangarajan, Sunil Shah, Chintan V Seigneux, Sophie De Campedel, Luca Kitchlu, Abhijat Shin, Daniel Sanghoon Coppock, Gaia Ortiz-Melo, David I Sprangers, Ben Aggarwal, Vikram Benesova, Karolina Wanchoo, Rimda Murakami, Naoka Cortazar, Frank B Reynolds, Kerry L Sise, Meghan E Soler, Maria Jose Leaf, David E |
author_facet | Gupta, Shruti Garcia-Carro, Clara Prosek, Jason M Glezerman, Ilya Herrmann, Sandra M Garcia, Pablo Abudayyeh, Ala Lumlertgul, Nuttha Malik, A Bilal Loew, Sebastian Beckerman, Pazit Renaghan, Amanda D Carlos, Christopher A Rashidi, Arash Mithani, Zain Deshpande, Priya Rangarajan, Sunil Shah, Chintan V Seigneux, Sophie De Campedel, Luca Kitchlu, Abhijat Shin, Daniel Sanghoon Coppock, Gaia Ortiz-Melo, David I Sprangers, Ben Aggarwal, Vikram Benesova, Karolina Wanchoo, Rimda Murakami, Naoka Cortazar, Frank B Reynolds, Kerry L Sise, Meghan E Soler, Maria Jose Leaf, David E |
author_sort | Gupta, Shruti |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9511654 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-95116542022-09-27 Shorter versus longer corticosteroid duration and recurrent immune checkpoint inhibitor-associated AKI Gupta, Shruti Garcia-Carro, Clara Prosek, Jason M Glezerman, Ilya Herrmann, Sandra M Garcia, Pablo Abudayyeh, Ala Lumlertgul, Nuttha Malik, A Bilal Loew, Sebastian Beckerman, Pazit Renaghan, Amanda D Carlos, Christopher A Rashidi, Arash Mithani, Zain Deshpande, Priya Rangarajan, Sunil Shah, Chintan V Seigneux, Sophie De Campedel, Luca Kitchlu, Abhijat Shin, Daniel Sanghoon Coppock, Gaia Ortiz-Melo, David I Sprangers, Ben Aggarwal, Vikram Benesova, Karolina Wanchoo, Rimda Murakami, Naoka Cortazar, Frank B Reynolds, Kerry L Sise, Meghan E Soler, Maria Jose Leaf, David E J Immunother Cancer Clinical/Translational Cancer Immunotherapy 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. BMJ Publishing Group 2022-09-22 /pmc/articles/PMC9511654/ /pubmed/36137651 http://dx.doi.org/10.1136/jitc-2022-005646 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Clinical/Translational Cancer Immunotherapy Gupta, Shruti Garcia-Carro, Clara Prosek, Jason M Glezerman, Ilya Herrmann, Sandra M Garcia, Pablo Abudayyeh, Ala Lumlertgul, Nuttha Malik, A Bilal Loew, Sebastian Beckerman, Pazit Renaghan, Amanda D Carlos, Christopher A Rashidi, Arash Mithani, Zain Deshpande, Priya Rangarajan, Sunil Shah, Chintan V Seigneux, Sophie De Campedel, Luca Kitchlu, Abhijat Shin, Daniel Sanghoon Coppock, Gaia Ortiz-Melo, David I Sprangers, Ben Aggarwal, Vikram Benesova, Karolina Wanchoo, Rimda Murakami, Naoka Cortazar, Frank B Reynolds, Kerry L Sise, Meghan E Soler, Maria Jose Leaf, David E Shorter versus longer corticosteroid duration and recurrent immune checkpoint inhibitor-associated AKI |
title | Shorter versus longer corticosteroid duration and recurrent immune checkpoint inhibitor-associated AKI |
title_full | Shorter versus longer corticosteroid duration and recurrent immune checkpoint inhibitor-associated AKI |
title_fullStr | Shorter versus longer corticosteroid duration and recurrent immune checkpoint inhibitor-associated AKI |
title_full_unstemmed | Shorter versus longer corticosteroid duration and recurrent immune checkpoint inhibitor-associated AKI |
title_short | Shorter versus longer corticosteroid duration and recurrent immune checkpoint inhibitor-associated AKI |
title_sort | shorter versus longer corticosteroid duration and recurrent immune checkpoint inhibitor-associated aki |
topic | Clinical/Translational Cancer Immunotherapy |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9511654/ https://www.ncbi.nlm.nih.gov/pubmed/36137651 http://dx.doi.org/10.1136/jitc-2022-005646 |
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