Key result
Immune checkpoint inhibitors are most commonly linked to myocarditis among cardiovascular immune-related adverse events.
Why the study?
Reports of cardiovascular immune-related adverse events associated with immune checkpoint inhibitor therapy exhibit considerable heterogeneity between clinical trials and real-world observational studies.
What are the common cardiovascular immune-related adverse events, treatments, and outcomes associated with immune checkpoint inhibitor therapy?
Systematic Review (n=116)
What are the common cardiovascular immune-related adverse events, treatments, and outcomes associated with immune checkpoint inhibitor therapy?
Myocarditis is the most common cardiovascular adverse event of immune checkpoint inhibitors, typically requiring ICI discontinuation and corticosteroid therapy.
BACKGROUND: Reports of immune checkpoint inhibitor (ICI) therapy-associated immune-related adverse events (irAEs) exhibit considerable heterogeneity, particularly when comparing data from clinical trials and real-world observational studies. METHODS: We conducted a systematic review of real-world observational studies (case reports and series) reporting cardiovascular irAEs in PubMed and Embase from inception to April 1, 2024. We analyzed 116 case reports from 115 studies and highlighted the commonest irAEs, treatments instituted, and ensuing outcomes. RESULTS: Myocarditis was the most common, accompanied frequently by pericarditis and heart failure. Treatment typically included corticosteroids and discontinuation of ICI therapy. Higher doses of corticosteroids appeared promising. Refractory cases benefited from plasmapheresis, intravenous immunoglobulin, mycophenolate, tacrolimus, or infliximab. Rechallenging ICI therapy after irAEs resulted in mixed outcomes. CONCLUSIONS: Given the heterogeneity of data, analysis of aggregated data from central repositories like Side Effect Registry Immuno-Oncology (SERIO) would be invaluable.
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Godin et al. (2026) conducted a systematic review in Cardiovascular immune-related adverse events (n=116). Immune checkpoint inhibitors was evaluated on Commonest cardiovascular immune-related adverse events, treatments instituted, and ensuing outcomes. In 116 case reports, immune checkpoint inhibitor therapy was most commonly associated with myocarditis, frequently accompanied by pericarditis and heart failure, typically treated with corticosteroids.
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