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Preexisting autoimmune disease is a risk factor for immune-related adverse events : a meta-analysis

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Title: Preexisting autoimmune disease is a risk factor for immune-related adverse events : a meta-analysis
Authors: Yamaguchi, Atsushi Browse this author →KAKEN DB
Saito, Yoshitaka Browse this author →KAKEN DB
Okamoto, Keisuke Browse this author
Narumi, Katsuya Browse this author →KAKEN DB
Furugen, Ayako Browse this author →KAKEN DB
Takekuma, Yoh Browse this author →KAKEN DB
Sugawara, Mitsuru Browse this author →KAKEN DB
Kobayashi, Masaki Browse this author →KAKEN DB
Keywords: Immune checkpoint inhibitors (ICIs)
Immune-related adverse events (irAEs)
Preexisting autoimmune disease (PAD)
Issue Date: 23-Jun-2021
Publisher: Springer
Journal Title: Supportive care in cancer
Volume: 29
Start Page: 7747
End Page: 7753
Publisher DOI: 10.1007/s00520-021-06359-7
Abstract: Purpose Patients with preexisting autoimmune disease (PAD) are often excluded from clinical trials assessing immune checkpoint inhibitors (ICIs). Therefore, the safety of ICI therapy in patients with PAD remains unclear. Herein, we evaluated the incidence of immune-related adverse events (irAEs) in patients with PAD when compared with non-PAD patients. Methods We searched MEDLINE/PubMed, Web of Science, and Google Scholar for eligible studies from inception to January 2021. Observational studies reporting the incidence of irAEs in patients with and without PAD were included. We then performed a meta-analysis of eligible studies using forest plots. The primary endpoint of this study was the incidence rate of irAEs between patients with and without PAD. Results We identified three prospective and three retrospective studies involving 206 patients with PAD and 3078 patients without PAD. In the meta-analysis, 128 patients with PAD (62.1%) experienced irAEs, which occurred in 51.9% of non-PAD patients, resulting in an odds ratio (OR) of 2.14 (95% confidence interval [CI] 1.58–2.89). In the subgroup analysis, the incidence of irAEs was significantly higher in patients with PAD (OR = 2.19, 95% CI [1.55–3.08]). Furthermore, no significant heterogeneity or publication bias was detected, indicating that our meta-analysis could be generalized to clinical settings. Conclusion This meta-analysis demonstrated that PAD was a risk factor for irAE incidence. These results suggest that monitoring the occurrence of irAEs in patients with PAD is required to manage irAEs appropriately.
Rights: This is a post-peer-review, pre-copyedit version of an article published in Supportive care in cancer. The final authenticated version is available online at:
Type: article (author version)
Appears in Collections:薬学研究院 (Faculty of Pharmaceutical Sciences) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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