ArticleFrontline gastroenterology2019
Immunotherapy-related hepatitis: real-world experience from a tertiary centre.
Article in Frontline gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 56 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
56 citing papers in PubMed, 6 syntheses or guidelines pooled it, 96 citations in OpenAlex.
- Systematic review of immune checkpoint inhibitor-related gastrointestinal, hepatobiliary, and pancreatic adverse events.Journal for immunotherapy of cancer · 2024Pooled it
- Steroid-refractory immune checkpoint inhibitor (ICI) hepatitis and ICI rechallenge: A systematic review and meta-analysis.Hepatology communications · 2024Pooled it
- Corticosteroid-resistant immune-related adverse events: a systematic review.Journal for immunotherapy of cancer · 2024Pooled it
- Impact of steroid-sparing immunosuppressive agents on tumor outcome in the context of cancer immunotherapy with highlight on melanoma: a systematic literature review and meta-analysis.Frontiers in immunology · 2024Pooled it
- Effectiveness of immunosuppressant use for the treatment of immune checkpoint inhibitor-induced liver injury: A systematic review and meta-analysis.Frontiers in oncology · 2023Pooled it
- Immune-related cholangitis induced by immune checkpoint inhibitors: a systematic review of clinical features and management.European journal of gastroenterology & hepatology · 2021Pooled it
- The Immune Checkpoint Inhibitors Journey: From Early Promise to Lasting Impact.Journal of immunotherapy and precision oncology · 2026Review
- Nivolumab after recurrent pembrolizumab-associated hepatotoxicity in PD-L1-high metastatic squamous non-small cell lung cancer: a case report.Oxford medical case reports · 2026Article
- Treatment and outcomes of immunotherapy related colitis and hepatitis- a multi-centre cohort study in the United Kingdom by the National Oncology Trainee Collaborative for Healthcare Research (NOTCH).Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Immune Checkpoint Inhibitor-induced Liver Injury: A Critical Appraisal of Treatment and Rechallenge Controversies.Journal of clinical and translational hepatology · 2026Article
- Article
- Utilization of Steroid Sparing Agents for Immune-Related Adverse Events (irAEs): Management Strategies and Considerations.Current oncology reports · 2026Review
- Risk factors and outcomes for steroid-refractory immune-related hepatotoxicity in locally advanced and metastatic cancer.Cancer immunology, immunotherapy : CII · 2026Article
- RUCAM-ascertained immunology and autoimmunity specifics of six idiosyncratic drug-induced liver injury types with refined classification: their individual complex molecular interplay.Frontiers in immunology · 2026Review
- Balancing act: Tapering mycophenolate mofetil in immune checkpoint inhibitor hepatitis-strategies, outcomes, and risks.World journal of gastrointestinal pharmacology and therapeutics · 2025Article
- Article
- Advances in mechanistic investigation and treatment of steroid-refractory ICI-induced liver injury.Clinical and experimental medicine · 2025Review
- Immune-Mediated Liver Injury From Checkpoint Inhibitor: An Evolving Frontier With Emerging Challenges.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Drug-Induced Liver Injury Associated With Emerging Cancer Therapies.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Tacrolimus and mycophenolate mofetil in corticosteroid-resistant hepatitis secondary to tislelizumab: a case report.Frontiers in oncology · 2025Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveImmune checkpoint inhibitors like anti-programmed cell death protein 1 (PD-1) drugs Nivolumab and Pembrolizumab and anti-cytotoxic T-lymphocyte associated (CTLA-4) drug Ipilimumab have become standard of care in many metastatic cancers. Immunotherapy-related hepatitis and cholangitis present a diagnostic and management challenge, being rare and incompletely characterised. We aim to report the incidence, features and treatments used for this in a real-world setting and to identify useful biomarkers, which can be used to predict effective use of steroids.
designRetrospective review of 453 patients started on immunotherapy over 7 years.
settingTertiary hepatology and oncology centre. PATIENTS: 21 patients identified with immunotherapy-related hepatotoxicity.
resultsHepatitis was most common in those receiving dual therapy (incidence 20%), with 75% of Grade 4 hepatitis cases occurring with ipilimumab-containing regimens. Corticosteroid monotherapy is first line treatment, but doses above 60 mg OD prednisolone do not demonstrate any additional benefit in time to hepatitis resolution. The alanine transaminase (ALT) reduction in steroid-responsive hepatitis is typically rapid (with a halving of ALT within 11 days). The commencement of additional immunosuppression (typically mycophenolate) appears safe and prompts a more rapid fall in ALT than corticosteroid use alone. Infliximab was safely used twice as hepatitis treatment. We also describe one patient with rare immunotherapy-induced biliary disease.
conclusionsVigilance is required for detection of immunotherapy-associated liver disease as, other than dual immunotherapy, we can identify no predictive factors for its development. Our data suggest that corticosteroid response is not dependent on the higher dosing regimens. Early escalation of immunosuppression may be of benefit in the absence of a rapid response to corticosteroids.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.