Pembrolizumab use was associated with serious cardiac adverse events (34.3% fatal), with no difference in cardiotoxicity found between different immune checkpoint inhibitors.
Observational (n=6,719)
Is pembrolizumab associated with a higher frequency of cardiac adverse events compared to other medications or other ICIs?
Pembrolizumab and other immune checkpoint inhibitors are associated with severe and highly fatal cardiac adverse events, highlighting the need for vigilance in cardio-oncology.
BACKGROUND: Immune checkpoint inhibitors (ICIs) have been successfully used in the previous decade for the treatment of a variety of malignancies. Adverse events (AEs) can cause many symptoms, most notably cardiac. We analyzed the frequency of these adverse events, comparing pembrolizumab and other ICIs. METHODS: Using the Food and Drug Administration (FDA) adverse event reporting database (FAERS), we searched for all adverse events of interest reported for every ICI included in this study. After obtaining the data, we conducted a disproportionality analysis using the reporting odds ratio (ROR) and the information component (IC). RESULTS: A total of 6719 ICI-related cardiac adverse events of interest were reported in the database. Serious outcomes were reported in 100% of the cases, with 34.3% of the cases ending fatally. Compared with all other medications in the database, pembrolizumab use was more frequently associated with myocarditis, pericardial disease, heart failure, and atrial fibrillation. No difference was found in cardiotoxicity between different ICIs. CONCLUSIONS: Although infrequent, cardiac AEs in pembrolizumab use are associated with serious outcomes and high mortality. Prospective studies are needed to further research the connection between ICI use and cardiotoxicity.
Milutinovic et al. (Tue,) conducted a observational in Immune checkpoint inhibitor-related cardiac adverse events (n=6,719). Pembrolizumab vs. Other immune checkpoint inhibitors and all other medications was evaluated on Frequency of cardiac adverse events (myocarditis, pericardial disease, heart failure, and atrial fibrillation). Pembrolizumab use was associated with serious cardiac adverse events (34.3% fatal), with no difference in cardiotoxicity found between different immune checkpoint inhibitors.