Incidence, mortality, and risk factors of immunotherapy-associated hepatotoxicity: A nationwide hospitalization analysis.
Hepatotoxicity
Liver enzymes
Mortality
Outcomes
Risk factors
Tumor immunotherapy
Journal
Liver research
ISSN: 2096-2878
Titre abrégé: Liver Res
Pays: China
ID NLM: 101705555
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
entrez:
8
4
2021
pubmed:
9
4
2021
medline:
9
4
2021
Statut:
ppublish
Résumé
Anti-neoplastic immunotherapy has revolutionized cancer management; however. its safety profile with respect to liver-related injury remains largely unexplored. Herein, we analyzed a United States national database to determine the incidence, mortality, and predictors of hepatotoxicity in the setting of anti-neoplastic immunotherapy. This was a nationwide retrospective study of hospital encounters from 2011 to 2014 using the National Inpatient Sample (NIS) database. We utilized the International Classification of Diseases, Ninth Revision (ICD-9) coding system to identify all adult patients who underwent anti-neoplastic immunotherapy during hospitalization. The primary outcome was the incidence of hepatotoxicity during the same hospitalization. Secondary outcomes included in-hospital mortality as well as socioeconomic and ethno-racial predictors of hepatotoxicity. Analyses were performed using IBM SPSS Statistics 23.0. The sample included 3002 patients who underwent inpatient anti-neoplastic immunotherapy. The incidence of hepatotoxicity was 10.1%, which was significantly higher as compared to a matched inpatient population (adjusted odds ratio (aOR) 4.93, 95% confidence interval (CI): 3.80-6.40. In this large, nationwide database analysis, we found that anti-neoplastic immunotherapy was associated with a nearly five-fold risk of in-hospital hepatotoxicity as compared to a matched inpatient population, though without an associated mortality difference. Additionally, younger age and white race were identified as predictors of immunotherapy-associated hepatotoxicity. Heightened vigilance and prospective investigation of the risk factors and liver-related adverse effects of anti-neoplastic immunotherapy are warranted.
Sections du résumé
BACKGROUND AND AIMS
OBJECTIVE
Anti-neoplastic immunotherapy has revolutionized cancer management; however. its safety profile with respect to liver-related injury remains largely unexplored. Herein, we analyzed a United States national database to determine the incidence, mortality, and predictors of hepatotoxicity in the setting of anti-neoplastic immunotherapy.
METHODS
METHODS
This was a nationwide retrospective study of hospital encounters from 2011 to 2014 using the National Inpatient Sample (NIS) database. We utilized the International Classification of Diseases, Ninth Revision (ICD-9) coding system to identify all adult patients who underwent anti-neoplastic immunotherapy during hospitalization. The primary outcome was the incidence of hepatotoxicity during the same hospitalization. Secondary outcomes included in-hospital mortality as well as socioeconomic and ethno-racial predictors of hepatotoxicity. Analyses were performed using IBM SPSS Statistics 23.0.
RESULTS
RESULTS
The sample included 3002 patients who underwent inpatient anti-neoplastic immunotherapy. The incidence of hepatotoxicity was 10.1%, which was significantly higher as compared to a matched inpatient population (adjusted odds ratio (aOR) 4.93, 95% confidence interval (CI): 3.80-6.40.
CONCLUSIONS
CONCLUSIONS
In this large, nationwide database analysis, we found that anti-neoplastic immunotherapy was associated with a nearly five-fold risk of in-hospital hepatotoxicity as compared to a matched inpatient population, though without an associated mortality difference. Additionally, younger age and white race were identified as predictors of immunotherapy-associated hepatotoxicity. Heightened vigilance and prospective investigation of the risk factors and liver-related adverse effects of anti-neoplastic immunotherapy are warranted.
Identifiants
pubmed: 33828870
doi: 10.1016/j.livres.2021.01.003
pmc: PMC8023224
mid: NIHMS1667477
doi:
Types de publication
Journal Article
Langues
eng
Pagination
28-32Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR000135
Pays : United States
Déclaration de conflit d'intérêts
Declaration of competing interest The authors declare that they have no conflict of interest.
Références
J Clin Oncol. 2015 Jun 20;33(18):2092-9
pubmed: 25918278
Methods. 2021 Apr;188:61-72
pubmed: 33271285
Curr Med Chem. 2020 Oct 13;:
pubmed: 33050856
J Oncol Pharm Pract. 2021 Mar;27(2):395-404
pubmed: 33050805
Cancers (Basel). 2020 Jul 07;12(7):
pubmed: 32645977
Front Immunol. 2020 Apr 28;11:683
pubmed: 32411132
Liver Int. 2018 Jun;38(6):976-987
pubmed: 29603856
J Gastroenterol Hepatol. 2020 Jun;35(6):1042-1048
pubmed: 31752049
Mod Pathol. 2018 Jun;31(6):965-973
pubmed: 29403081
Lancet Oncol. 2015 Feb;16(2):e58
pubmed: 25601339
J Hepatol. 2018 Jun;68(6):1181-1190
pubmed: 29427729
Oncologist. 2021 Jan;26(1):49-55
pubmed: 33044765
Int J Cancer. 2017 Sep 1;141(5):1018-1028
pubmed: 28263392
Gut Pathog. 2020 Sep 10;12:43
pubmed: 32944086