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Lessard-Roy A, Marchand R, Lemieux P, Masse M, Lacerte A, Carmichael PH, Laurin D. Immune checkpoint inhibitors and risk of immune-mediated adverse events: a cohort study comparing extended versus standard interval administration. Clin Exp Med 2024; 24:40. [PMID: 38386053 PMCID: PMC10884063 DOI: 10.1007/s10238-024-01301-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 01/19/2024] [Indexed: 02/23/2024]
Abstract
The COVID-19 pandemic precipitated the implementation of extended interval immune checkpoint inhibitors (ICIs) in an effort to limit hospital visits, but few studies have examined their safety. This study aimed to compare in oncology outpatients, immune-mediated adverse events (IMAEs) in terms of total number, incidence, severity, and time to occurrence, based on exposure to standard or extended interval ICIs. A retrospective cohort study was conducted in patients who received at least one dose of an ICI between 2015 and 2021. Data were collected from patient records and pharmacy software. Adjusted logistic, Poisson, and Cox regression models were estimated. A total of 310 patients with a mean age of 67.1 years were included, 130 of whom had the extended interval. No statistically significant differences were observed between the groups. With the standard and extended intervals, the mean total number of IMAE per participant was 1.02 and 1.18, respectively; the incidence of an IMAE was 62% and 64%. Of the 147 IMAE episodes in the standard interval group, 14 (9.5%) were grade 3 or higher, while there were 15 (12.4%) among the 121 IMAE episodes in the extended interval group. Compared with standard interval, the use of extended interval did not increase the risk of having a first IMAE (adjusted hazard ratio 0.92 (95% CI 0.67-1.26)). This study suggests that the administration of an ICI according to extended interval is as safe as the administration according to standard interval in oncology outpatients.
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Affiliation(s)
- Amélia Lessard-Roy
- Faculté de Pharmacie, Université Laval, Québec, QC, Canada
- Département de Pharmacie, Hôpital Sainte-Croix, Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec, Drummondville, Canada
| | - Roxanne Marchand
- Faculté de Pharmacie, Université Laval, Québec, QC, Canada
- Département de Pharmacie, Centre Hospitalier Affilié Universitaire Régional de Trois-Rivières, Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec, 1991 Boul. du Carmel, Trois-Rivières, QC, G8Z 3R9, Canada
| | - Pierre Lemieux
- Faculté de Pharmacie, Université Laval, Québec, QC, Canada.
- Département de Pharmacie, Centre Hospitalier Affilié Universitaire Régional de Trois-Rivières, Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec, 1991 Boul. du Carmel, Trois-Rivières, QC, G8Z 3R9, Canada.
| | - Mélanie Masse
- Faculté de Pharmacie, Université Laval, Québec, QC, Canada
- Département de Pharmacie, Centre Hospitalier Affilié Universitaire Régional de Trois-Rivières, Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec, 1991 Boul. du Carmel, Trois-Rivières, QC, G8Z 3R9, Canada
| | | | - Pierre-Hugues Carmichael
- Faculté de Pharmacie, Université Laval, Québec, QC, Canada
- Centre d'excellence sur le Vieillissement de Québec, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale, Québec, Canada
| | - Danielle Laurin
- Faculté de Pharmacie, Université Laval, Québec, QC, Canada
- Centre d'excellence sur le Vieillissement de Québec, Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale Nationale, Québec, Canada
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