ArticleAlimentary pharmacology & therapeutics2024
Time to use the right classification to predict the severity of checkpoint inhibitor-induced liver injury, as assessed for causality using the updated RUCAM.
Article in Alimentary pharmacology & therapeutics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Clinical features and management for CDK4/6 inhibitor-DILI.JHEP reports : innovation in hepatology · 2026Article
- Autoimmune Pancreatitis Re-Classification with Novel Type AIP-4.International journal of molecular sciences · 2026Review
- Article
- 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
- From mechanisms to practice: risk management and multidisciplinary decision-making for systemic treatment-related liver injury in HBV-associated hepatocellular carcinoma.Frontiers in pharmacology · 2026Review
- Life-threatening immune-related adverse events in the intensive care unit: a narrative review.Intensive care medicine · 2025Review
- Drug-Induced Autoimmune Hepatitis by Varenicline and Infliximab as a Continuous Disease Spectrum with Two Different Flares: Acute Liver Injury Followed by Hepatic Autoimmunity.International journal of molecular sciences · 2025Review
- Navigating liver toxicity in the age of novel oncological agents.JHEP reports : innovation in hepatology · 2025Review
- Drug-Induced Autoimmune Hepatitis: Robust Causality Assessment Using Two Different Validated and Scoring Diagnostic Algorithms.Diagnostics (Basel, Switzerland) · 2025Review
- Ursodeoxycholic Acid Alone Is Effective and Safe to Treat Cholestatic Checkpoint Inhibitor-Induced Liver Injury.Liver international : official journal of the International Association for the Study of the Liver · 2025Article
- 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
- Time to use the right classification to predict the severity of checkpoint inhibitor-induced liver injury, as assessed for causality using the updated RUCAM.Alimentary pharmacology & therapeutics · 2024Article
- Balancing Tumor Immunotherapy and Immune-Related Adverse Events: Unveiling the Key Regulators.International journal of molecular sciences · 2024Review
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Authors and funding
17 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsWhile immune checkpoint inhibitors (ICIs) are revolutionising cancer therapy, checkpoint inhibitor-induced liver injury is a significant immune-related side effect of this immunotherapy. This study focuses on the severity classifications and characteristics of patients with checkpoint inhibitor-induced hepatitis.
methodsA retrospective analysis of patients with severe Checkpoint Inhibitor-induced hepatitis grade 3 and 4 according to the recommended Common Terminology Criteria for Adverse Events (CTCAE) classification was conducted. Data on clinicobiological characteristics, treatment and outcomes were collected from 3 university hospitals, and causality was assessed by using the updated Roussel Uclaf Causality Assessment Method. The severity of hepatitis was assessed using the Model for End-stage Liver Disease score, the Drug-Induced Liver Injury Network, and the Drug-Induced Liver Injury International Expert Working Group classifications.
resultsWe retrospectively included 100 patients presenting various hepatitis patterns with a median time to onset of 20 days after checkpoint inhibitors. Severity grading varied significantly among the classifications used. A lower incidence of severe cases was observed when using the Drug-Induced Liver Injury classifications instead of the recommended CCTCAE classification, and this was correlated with outcomes.
conclusionsThis retrospective study challenges the efficacy of the CTCAE classification in defining the severity of Checkpoint Inhibitor-induced hepatitis and suggests that the traditional hepatology-focused scores may be more relevant. The CTCAE classification is inconsistent and gives equal weight to jaundice and elevated transaminases, which leads to steroid overtreatment and limits the rechallenge of ICIs.
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