Abstract: FR-PO182
Shorter vs. Longer Corticosteroid Duration and Recurrent Immune Checkpoint Inhibitor-Associated AKI
Session Information
- Onconephrology: Clinical and Research Advances - I
November 04, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1600 Onconephrology
Authors
- Gupta, Shruti, Brigham and Women's Hospital, Boston, Massachusetts, United States
- García-Carro, Clara, San Carlos Clinical Hospital, Madrid, Spain
- Sise, Meghan E., Massachusetts General Hospital, Boston, Massachusetts, United States
- Soler, Maria Jose, Vall d’Hebron University Hospital, Barcelona, Spain
- Leaf, David E., Brigham and Women's Hospital, Boston, Massachusetts, United States
Group or Team Name
- ICPi-AKI Consortium
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 events and possibly decreased progression-free survival among patients treated with ICPis. We therefore sought to determine whether a shorter duration of corticosteroids was equally efficacious and safe as compared to a longer duration.
Methods
We used data from our previously conducted multicenter cohort study of patients diagnosed with ICPi-AKI from 29 centers across 9 countries. We examined whether a shorter duration of corticosteroids (28 days or less) versus a longer duration of corticosteroids (29-84 days) was associated with a higher rate of recurrent ICPi-AKI or death in the 30-day period following completion of corticosteroid treatment.
Results
Of 165 patients treated with corticosteroids, 56 (34%) received a shorter duration of treatment and 109 (66%) received a longer duration. Patients in these two groups were similar with respect to age, sex, race, malignancy type, and baseline kidney function. 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 (Log-rank P=0.90) (Figure A). Nadir serum creatinine in the first 14, 28, and 90 days following completion of corticosteroid treatment was similar in the shorter versus longer duration groups (P=0.40, P=0.56, and P=0.89, respectively) (Figure B).
Conclusion
A duration of corticosteroids of 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.