Abstract | BACKGROUND: METHODS: RESULTS: During the follow-up period (median, 252 days), 58 patients (4.8%) had an immune-related liver injury (≥ Grade 3). The liver-injury patterns were hepatocellular (n = 26, 44.8%), mixed (n = 11, 19.0%), or cholestatic (n = 21, 36.2%), and the median time to onset of liver injury was 39, 81, and 53 days, respectively; the hepatocellular pattern occurred earlier than the other types (p = 0.047). Corticosteroids were administered to 30 (51.7%) patients; while liver injury was improved in almost all patients with the hepatocellular pattern (n = 13/14, 92.9%), that failed to show improvement in over half of the patients with the non-hepatocellular patterns, and three patients with mixed patterns needed secondary immunosuppression with mycophenolate mofetil. Liver biopsies performed in 13 patients mainly showed lobular injury, endothelialitis, and spotty necrosis with infiltration of T cells positive for CD3 and CD8, but not CD4 or CD20. CONCLUSION: The incidence pattern and therapeutic response to corticosteroids in immune-related liver injury differ according to the injury type. Although corticosteroids were effective for the hepatocellular pattern, an additional strategy for refractory non-hepatocellular patterns is needed.
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Authors | Takanori Ito, Masatoshi Ishigami, Takafumi Yamamoto, Kazuyuki Mizuno, Kenta Yamamoto, Norihiro Imai, Yoji Ishizu, Takashi Honda, Hiroki Kawashima, Satoshi Yasuda, Hidenori Toyoda, Kenji Yokota, Tetsunari Hase, Naoki Nishio, Osamu Maeda, Masashi Kato, Naozumi Hashimoto, Hideharu Hibi, Yasuhiro Kodera, Michihiko Sone, Yuichi Ando, Masashi Akiyama, Yoshie Shimoyama, Mitsuhiro Fujishiro |
Journal | Hepatology international
(Hepatol Int)
Vol. 15
Issue 5
Pg. 1278-1287
(Oct 2021)
ISSN: 1936-0541 [Electronic] United States |
PMID | 34373964
(Publication Type: Journal Article)
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Copyright | © 2021. Asian Pacific Association for the Study of the Liver. |
Chemical References |
- Immune Checkpoint Inhibitors
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Topics |
- Carcinoma, Hepatocellular
(drug therapy)
- Humans
- Immune Checkpoint Inhibitors
- Immune Tolerance
- Liver Neoplasms
(drug therapy)
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