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Acid suppressants reduce the therapeutic effect of immune checkpoint inhibitors and increase the risk of acute kidney injury: a meta-analysis
| Title: | Acid suppressants reduce the therapeutic effect of immune checkpoint inhibitors and increase the risk of acute kidney injury: a meta-analysis |
| Authors: | Okamoto, Keisuke Browse this author | | Saito, Yoshitaka Browse this author →KAKEN DB | | Yamaguchi, Atsushi Browse this author →KAKEN DB | | Takekuma, Yoh Browse this author →KAKEN DB | | Sugawara, Mitsuru Browse this author →KAKEN DB |
| Keywords: | Immune checkpoint inhibitor | | Acid suppressant | | Proton pump inhibitor | | Histamine H2-receptor antagonist | | Immune-related adverse events |
| Issue Date: | 8-Jul-2023 |
| Publisher: | Springer |
| Journal Title: | International journal of clinical oncology |
| Volume: | 28 |
| Start Page: | 1343 |
| End Page: | 1353 |
| Publisher DOI: | 10.1007/s10147-023-02385-z |
| Abstract: | BackgroundImmune checkpoint inhibitors (ICIs) are used in cancer immunotherapy; however, they can lead to immune-related adverse events (irAEs) through immune function of patients. Therefore, this meta-analysis aimed to assess the concomitant effect of acid suppressants (ASs) on ICIs, including several subgroup analyses.MethodsWe identified related studies and generated the forest plot. The primary endpoint was defined as the change in progression free survival (PFS) and overall survival (OS) with or without ASs administration. We also evaluated the effect of ASs on the incidence of irAEs.ResultsThe total hazard ratio (HR) of ASs on PFS with ICI treatment was 1.39 and the 95% confidence interval (95% CI) was 1.21-1.59 (Z: p < 0.00001). Moreover, the total HR of ASs on OS was 1.40 and the 95% CI was 1.21-1.61 (Z: p < 0.00001), suggesting that ASs reduced ICI's therapeutic effect. The total odds ratio (OR) for evaluating the effect of ASs on irAEs was 1.23 with a 95% CI of 0.81-1.88 (Z: p = 0.34). However, ASs significantly worsened acute kidney injury (AKI) (total OR 2.10; 95% CI 1.74-2.53 (Z, p < 0.00001)). Furthermore, although proton pump inhibitors (PPIs) reduced ICI's therapeutic effect, histamine H2-receptor antagonists (H2RAs) did not affect OS.ConclusionsIt was shown that ASs, especially PPIs, reduced ICI's therapeutic effect, while H2RAs had no effect, and ASs did not affect irAEs; however, it is a risk factor for ICIs-induced AKI. |
| Rights: | This version of the article has been accepted for publication, after peer review and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/https://dx.doi.org/10.1007/s10147-023-02385-z |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/93036 |
| 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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Submitter: 岡本 敬介
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