Key result
Baseline glucocorticoids ≥ 20 mg during the first ICI treatment cycle was associated with a significantly lower risk of cardiotoxic events (OR 0.4625; 95% CI 0.2514-0.7235; p=0.0020).
Why the study?
Existing research on glucocorticoids during immunotherapy focused on efficacy and outcomes, leaving their influence on immune checkpoint inhibitor-associated cardiotoxic events and myocardial damage unknown.
Does baseline glucocorticoids ≥ 20 mg reduce the risk of cardiotoxic events and myocardial damage in patients treated with immune checkpoint inhibitors?
Cohort (n=1,018)
No
Does baseline glucocorticoids ≥ 20 mg reduce the risk of cardiotoxic events and myocardial damage in patients treated with immune checkpoint inhibitors?
Baseline glucocorticoids ≥ 20 mg during the first cycle of immune checkpoint inhibitors is associated with a significantly reduced risk of subsequent cardiotoxic events and myocardial damage.
May support early glucocorticoids to lower ICI cardiotoxicity risk; leaves open need for randomized confirmation.
Background Immune checkpoint inhibitors (ICIs)-associated cardiotoxic events (CEs) are of increasing concern. Existing research about glucocorticoids (GCs) on immunotherapy focused on ICIs’ efficacy and patients’ outcome. The influence of GCs on ICIs-associated CEs and myocardial damage (MD) remains unknown.Research design and methods This single-center retrospective study included patients treated with ICIs from 2018 to 2022, with follow-up period ending on 30 June 2023. The incidence, risk factors of ICIs-associated CEs, especially MD were described. Additionally, the impact of baseline GCs was assessed by propensity score matching (PSM) to mitigate intergroup differences and ensure comparability.Results Among 1018 patients, 204 (20.04%) experienced ICIs-associated CEs, including 71 (6.97%) with MD. The mean follow-up time was 40.39 (95% CI 38.47–42.31) weeks. The median time to onset of MD was the shortest at 12.57 weeks (IQR 5.29–25.14). Tumor type, co-medication with platinum and angiogenesis inhibitors may be influential factors of MD. After PSM, the relative risks of CEs (OR 0.4625,95%CI 0.2514–0.7235, p = 0.0020) and MD (OR 0.3254, 95% CI 0.1190–0.8898, p = 0.0378) in GCs1 ≥ 20 mg group were both significantly lower than those in GCs1 < 20 mg.Conclusion GCs ≥ 20 mg during the first ICIs treatment cycle is significantly associated with the reduced risks of both ICIs-associated CEs and MD.
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Wang et al. (2025) conducted a cohort in Patients treated with immune checkpoint inhibitors (ICIs) (n=1,018). Baseline glucocorticoids (GCs) ≥ 20 mg vs. GCs < 20 mg was evaluated on ICIs-associated cardiotoxic events (CEs) (OR 0.4625, 95% CI 0.2514-0.7235, p=0.0020). Baseline glucocorticoids ≥ 20 mg during the first ICI treatment cycle was associated with a significantly lower risk of cardiotoxic events (OR 0.4625; 95% CI 0.2514-0.7235; p=0.0020).
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