Hepatotoxicity in immune checkpoint inhibitors: A pharmacovigilance study from 2014-2021

PLoS One. 2023 Mar 7;18(3):e0281983. doi: 10.1371/journal.pone.0281983. eCollection 2023.

Abstract

Adverse events(AEs) related to hepatotoxicity have been reported in patients treated with immune checkpoint inhibitors (ICIs). As the number of adverse events increases, it is necessary to assess the differences in each immune checkpoint inhibitor regimen. The purpose of this study was to examine the relationship between ICIs and hepatotoxicity in a scientific and systematic manner. Data were obtained from the FDA Adverse Event Reporting System database (FAERS) and included data from the first quarter of 2014 to the fourth quarter of 2021. Disproportionality analysis assessed the association between drugs and adverse reactions based on the reporting odds ratio (ROR) and information components (IC). 9,806 liver adverse events were reported in the FAERS database. A strong signal was detected in older patients (≥65 years) associated with ICIs. hepatic adverse events were most frequently reported with Nivolumab (36.17%). Abnormal liver function, hepatitis, and autoimmune hepatitis were most frequently reported, and hepatitis and immune-mediated hepatitis signals were generated in all regimens. In clinical use, patients should be alert to these adverse effects, especially in elderly patients, who may be aggravated by the use of ICI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chemical and Drug Induced Liver Injury* / epidemiology
  • Chemical and Drug Induced Liver Injury* / etiology
  • Drug-Related Side Effects and Adverse Reactions* / epidemiology
  • Humans
  • Immune Checkpoint Inhibitors / adverse effects
  • Nivolumab / adverse effects
  • Pharmacovigilance

Substances

  • Immune Checkpoint Inhibitors
  • Nivolumab

Associated data

  • Dryad/10.5061/dryad.69p8cz95z

Grants and funding

This study was funded by the National Natural Science Foundation of China (41310164).