Acid suppressants reduce the therapeutic effect of immune checkpoint inhibitors and increase the risk of acute kidney injury: a meta-analysis

Okamoto, Keisuke; Saito, Yoshitaka; Yamaguchi, Atsushi; Takekuma, Yoh; Sugawara, Mitsuru

Acid suppressants reduce the therapeutic effect of immune checkpoint inhibitors and increase the risk of acute kidney injury: a meta-analysis

Okamoto, Keisuke; Saito, Yoshitaka; Yamaguchi, Atsushi et al.

International journal of clinical oncology, 2023, 28, 1343-1353

Permalink : https://hdl.handle.net/2115/93036

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アクセス権	open access
URI	https://hdl.handle.net/2115/93036
タイトル	Acid suppressants reduce the therapeutic effect of immune checkpoint inhibitors and increase the risk of acute kidney injury: a meta-analysis
著者	Okamoto, Keisuke ; Saito, Yoshitaka ; Yamaguchi, Atsushi ; Takekuma, Yoh ; Sugawara, Mitsuru
著者名 Okamoto, Keisuke
e-Rad_Researcher 00835001 著者名 Saito, Yoshitaka
e-Rad_Researcher 50344495 著者名 Yamaguchi, Atsushi
e-Rad_Researcher 00396293 著者名 Takekuma, Yoh
e-Rad_Researcher 60332467 著者名 Sugawara, Mitsuru
言語	英語
キーワード	Immune checkpoint inhibitor
	Acid suppressant
	Proton pump inhibitor
	Histamine H2-receptor antagonist
	Immune-related adverse events
発行日	2023-07-08
出版者	Springer
収録物名	International journal of clinical oncology
巻(号)	28
ページ	1343-1353
抄録	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.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	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
PISSN	1341-9625
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s10147-023-02385-z