SynthesisEuropean journal of gastroenterology & hepatology2021
Immune-related cholangitis induced by immune checkpoint inhibitors: a systematic review of clinical features and management.
Synthesis in European journal of gastroenterology & hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
53 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- 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
- The Immune Checkpoint Inhibitors Journey: From Early Promise to Lasting Impact.Journal of immunotherapy and precision oncology · 2026Review
- Hepatic and Pancreatobiliary Immune-Related Adverse Events in Patients Receiving Immune Checkpoint Inhibitors: A Multidisciplinary Approach.Biomedicines · 2026Review
- Salvage tacrolimus therapy for steroid-refractory immune-related adverse event-associated sclerosing cholangitis.Clinical journal of gastroenterology · 2026Article
- Drug-Associated Vanishing Bile Duct Syndrome: Screening for Potential Pharmaceutical Triggers Using the WHO Pharmacovigilance Database.Life (Basel, Switzerland) · 2026Article
- Common Causes of Drug-Induced Liver Injury in 2025.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Review
- Cholangiocyte biology in primary sclerosing cholangitis and other cholangiopathies: pathogenesis, clinical insights, and experimental tools.Physiological reviews · 2026Review
- Beyond Rejection: Nivolumab-Induced Vanishing Bile Duct Syndrome as a Novel Pattern of Immune-Related Allograft Injury.Clinical transplantation · 2026Article
- Autoimmune Pancreatitis Re-Classification with Novel Type AIP-4.International journal of molecular sciences · 2026Review
- Bridging FDA Adverse Event Reporting System (FAERS) and Clinical Practice: Comprehensive Characterization of Immune Checkpoint Inhibitors Toxicities in Geriatric Lung Cancer Patients.Thoracic cancer · 2026Article
- Article
- Integrated pharmacovigilance assessment of drug-associated cholangitis: signal detection, clinical characterization, and mechanistic insights.Frontiers in pharmacology · 2026Article
- Immune checkpoint inhibitor-related cholangitis and pancreatitis induced by penpulimab: a case report.AME case reports · 2026Article
- Hepatobiliary surgery in the era of immunotherapy: integrating surgical timing, immune surveillance, and recurrence prevention.Frontiers in immunology · 2026Article
- [Diagnostics and therapy of gastroenterological side effects of immune checkpoint inhibitor therapy].Magyar onkologia · 2025Review
- Article
- Consensus on the Management of Liver Injury Associated with Targeted Drugs and Immune Checkpoint Inhibitors for Hepatocellular Carcinoma (Version 2024).Journal of clinical and translational hepatology · 2025Article
- Two Ducts, One Drug-Pembrolizumab-Induced Pancreatic Injury Manifesting as Double-Duct Sign.ACG case reports journal · 2025Article
- Rapid cholestasis improvement as key strategy for steroid-refractory immune-related cholangitis: A case report.World journal of gastrointestinal oncology · 2025Article
- Disproportionality analysis of adverse events associated with ipilimumab and nivolumab combination therapy based on FAERS database.Scientific reports · 2025Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND
aimsImmune checkpoint inhibitors (ICIs) improve the survival of patients with advanced tumors. However, immune-related adverse events limit the use of ICIs. Although liver toxicity has been concerned gradually, little is known about bile duct injury associated with ICIs. Hence, this review aims to describe clinicopathological features, imaging, and management of immune-mediated cholangitis (IMC) induced by ICIs.
methodsWe retrieved the literature from the PubMed database for case reports and series of IMC induced by ICIs. IMC was then classified as small-ducts type, large-ducts type and mixed type. Biochemical parameters, pathological characteristics, imaging features, treatment and response were evaluated and compared among three patterns.
resultsFifty-three cases of IMC were enrolled. The median values of alkaline phosphatase and alanine transaminase of IMC were 1328 and 156 IU/L. The ALP level of the large-ducts type was higher than that of the small-ducts type (P = 0.021). The main pathological characteristics of small-ducts cholangitis were portal inflammation, bile duct injury and ductular reaction. The imaging features of large-duct cholangitis were bile duct dilatation, stenosis and bile duct wall thickening and irregularity. Forty-eight (90%) cases received immunosuppression therapy. Biliary enzymes reduced in 79% of cases receiving immunosuppression therapy, but only 8.5% of cases returned to normal. It took a long time for biliary enzymes to recover.
conclusionsThe clinicians should be aware of the possibility of IMC if the biliary enzymes increase significantly after the use of ICIs. The liver function can be improved partially by immunosuppressive therapy in the majority of IMC.
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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.