1. Shorter versus longer corticosteroid duration and recurrent immune checkpoint inhibitor-associated AKI.
- Author
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Gupta, Shruti, Gupta, Shruti, Garcia-Carro, Clara, Prosek, Jason, Glezerman, Ilya, Herrmann, Sandra, Garcia, Pablo, Abudayyeh, Ala, Lumlertgul, Nuttha, Malik, A, Loew, Sebastian, Beckerman, Pazit, Renaghan, Amanda, Carlos, Christopher, Rashidi, Arash, Mithani, Zain, Deshpande, Priya, Rangarajan, Sunil, Shah, Chintan, Seigneux, Sophie, Campedel, Luca, Kitchlu, Abhijat, Shin, Daniel, Coppock, Gaia, Ortiz-Melo, David, Sprangers, Ben, Aggarwal, Vikram, Benesova, Karolina, Wanchoo, Rimda, Murakami, Naoka, Cortazar, Frank, Reynolds, Kerry, Sise, Meghan, Soler, Maria, Leaf, David, Gupta, Shruti, Gupta, Shruti, Garcia-Carro, Clara, Prosek, Jason, Glezerman, Ilya, Herrmann, Sandra, Garcia, Pablo, Abudayyeh, Ala, Lumlertgul, Nuttha, Malik, A, Loew, Sebastian, Beckerman, Pazit, Renaghan, Amanda, Carlos, Christopher, Rashidi, Arash, Mithani, Zain, Deshpande, Priya, Rangarajan, Sunil, Shah, Chintan, Seigneux, Sophie, Campedel, Luca, Kitchlu, Abhijat, Shin, Daniel, Coppock, Gaia, Ortiz-Melo, David, Sprangers, Ben, Aggarwal, Vikram, Benesova, Karolina, Wanchoo, Rimda, Murakami, Naoka, Cortazar, Frank, Reynolds, Kerry, Sise, Meghan, Soler, Maria, and Leaf, David
- Abstract
BACKGROUND: Corticosteroids are the mainstay of treatment for immune checkpoint inhibitor-associated acute kidney injury (ICPi-AKI), but the optimal duration of therapy has not been established. Prolonged use of corticosteroids can cause numerous adverse effects and may decrease progression-free survival among patients treated with ICPis. We sought to determine whether a shorter duration of corticosteroids was equally efficacious and safe as compared with a longer duration. METHODS: We used data from an international multicenter cohort study of patients diagnosed with ICPi-AKI from 29 centers across nine countries. We examined whether a shorter duration of corticosteroids (28 days or less) was associated with a higher rate of recurrent ICPi-AKI or death within 30 days following completion of corticosteroid treatment as compared with a longer duration (29-84 days). RESULTS: Of 165 patients treated with corticosteroids, 56 (34%) received a shorter duration of treatment and 109 (66%) received a longer duration. Patients in the shorter versus longer duration groups were similar with respect to baseline and ICPi-AKI characteristics. Five of 56 patients (8.9%) in the shorter duration group and 12 of 109 (11%) in the longer duration group developed recurrent ICPi-AKI or died (p=0.90). Nadir serum creatinine in the first 14, 28, and 90 days following completion of corticosteroid treatment was similar between groups (p=0.40, p=0.56, and p=0.89, respectively). CONCLUSION: A shorter duration of corticosteroids (28 days or less) may be safe for patients with ICPi-AKI. However, the findings may be susceptible to unmeasured confounding and further research from randomized clinical trials is needed.
- Published
- 2022