2022
DOI: 10.34172/mejdd.2022.279
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Immune Checkpoint Inhibitors Induced Hepatotoxicity; Gastroenterologists’ Perspectives

Abstract: BACKGROUND: Immune checkpoint inhibitors (ICIs) have promising clinical activity and are essential medications for patients with several malignancies. However, by deranging the immune system, these novel agents could lead to immune-related adverse events (IRAEs). Hepatotoxicity with checkpoint inhibitors usually results in acute hepatitis or drug-induced liver injury. METHODS: This review article discusses the recent clinical evidence available regarding checkpoint inhibitor-induced hepatitis and reviews an ap… Show more

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Cited by 3 publications
(3 citation statements)
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“…(5) Grade 5 liver injury: fatal liver injury ( 31 ). Histologically, ICIs can cause various forms of pathological damage to hepatocytes, including panlobular hepatitis, perivenular infiltrating endotheliitis or a cholestatic pattern with proliferative bile duct injury, and mixed portal inflammation with mild lobular necrotizing inflammation ( 82 ). Hepatotoxicity has been reported in 2% to 10% of patients receiving monotherapy with ipilimumab, nivolumab, and pembrolizumab.…”
Section: Common Iraesmentioning
confidence: 99%
See 1 more Smart Citation
“…(5) Grade 5 liver injury: fatal liver injury ( 31 ). Histologically, ICIs can cause various forms of pathological damage to hepatocytes, including panlobular hepatitis, perivenular infiltrating endotheliitis or a cholestatic pattern with proliferative bile duct injury, and mixed portal inflammation with mild lobular necrotizing inflammation ( 82 ). Hepatotoxicity has been reported in 2% to 10% of patients receiving monotherapy with ipilimumab, nivolumab, and pembrolizumab.…”
Section: Common Iraesmentioning
confidence: 99%
“…The mechanism of hepatotoxicity is currently unknown, and secondary activation of CD8+ cytotoxic T lymphocytes, various CD4+ T-cell populations, cytokines, and the innate immune system has been found to lead to liver injury (81). According to the serum aspartate aminotransferase (AST)/alanine aminotransferase (ALT) levels, liver injury can be divided into five grades: (1) Grade 1 liver damage: AST/ALT increased, less than 3 times the upper limit of the normal value: the level of total positive rates increased less than 1.5 times the upper limit of the normal value.…”
Section: Immune-mediated Hepatotoxicitymentioning
confidence: 99%
“…The condition most commonly manifests as isolated elevations in liver transaminases but can vary in severity, up to and including fulminant hepatic failure [7]. Early identification and appropriate management are critical components of mitigating the risks associated with ICI-induced hepatitis [8,9]. This review aims to provide overview of the epidemiology of ICI-induced hepatitis, exploring its clinical manifestations, diagnostic criteria, and management strategies.…”
Section: Introductionmentioning
confidence: 99%