{"doi":"10.1136/jitc-2021-002771","title":"Pericardial disease in patients treated with immune checkpoint inhibitors","abstract":"BACKGROUND: There are limited data on the occurrence, associations and outcomes of pericardial effusions and pericarditis on or after treatment with immune checkpoint inhibitors (ICIs). METHODS: This was a retrospective study at a single academic center that compared 2842 consecutive patients who received ICIs with 2699 age- and cancer-type matched patients with metastatic disease who did not receive ICI. A pericardial event was defined as a composite outcome of pericarditis and new or worsening moderate or large pericardial effusion. The endpoints were obtained through chart review and were blindly adjudicated. To identify risk factors associated with a pericardial event, we compared patients who developed an event on an ICI with patients treated with an ICI who did not develop a pericardial event. Cox proportional-hazard model and logistical regression analysis were performed to study the association between ICI use and pericardial disease as well as pericardial disease and mortality. An additional 6-week landmark analysis was performed to account for lead-time bias. RESULTS: There were 42 pericardial events in the patients treated with ICI (n=2842) over 193 days (IQR: 64-411), yielding an incidence rate of 1.57 events per 100 person-years. There was a more than fourfold increase in risk of pericarditis or a pericardial effusion among patients on an ICI compared with controls not treated with ICI after adjusting for potential confounders (HR 4.37, 95% CI 2.09 to 9.14, p<0.001). Patients who developed pericardial disease while on an ICI had a trend for increased all-cause mortality compared with patients who did not develop a pericardial event (HR 1.53, 95% CI 0.99 to 2.36, p=0.05). When comparing those who developed pericardial disease after ICI treatment with those who did not, a higher dose of corticosteroid pre-ICI (>0.7 mg/kg prednisone) was associated with increased risk of pericardial disease (HR 2.56, 95% CI 1.00 to 6.57, p=0.049). CONCLUSIONS: ICI use was associated with an increased risk of development of pericardial disease among patients with cancer and a pericardial event on an ICI was associated with a trend towards increase in mortality.","journal":"Journal for ImmunoTherapy of Cancer","year":2021,"id":151292,"datarank":0.6681520944380261,"base_score":4.454347296253507,"endowment":4.454347296253507,"self_citation_contribution":0.6681520944380261,"citation_network_contribution":0.0,"self_endowment_contribution":0.6681520944380261,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":85,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9597,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":308168,"name":"Zsófia D. Drobni","orcid":"0000-0002-1355-5318","position":1,"is_corresponding":false},{"id":308169,"name":"Amna Zafar","orcid":"0000-0003-2010-3018","position":2,"is_corresponding":false},{"id":642941,"name":"Thiago Quinaglia","orcid":"0000-0001-9099-3007","position":3,"is_corresponding":false},{"id":309885,"name":"Sarah Hartmann","orcid":null,"position":4,"is_corresponding":false},{"id":309886,"name":"Hannah Gilman","orcid":null,"position":5,"is_corresponding":false},{"id":402710,"name":"Vineet K. Raghu","orcid":"0000-0003-3524-3945","position":6,"is_corresponding":false},{"id":642942,"name":"Carlos A. Gongora","orcid":"0000-0002-0383-2086","position":7,"is_corresponding":false},{"id":263649,"name":"Meghan E. Sise","orcid":"0000-0002-4327-9713","position":8,"is_corresponding":false},{"id":234379,"name":"Raza M. Alvi","orcid":null,"position":9,"is_corresponding":false},{"id":105186,"name":"Leyre Zubiri","orcid":"0000-0003-4226-7443","position":10,"is_corresponding":false},{"id":232168,"name":"Anju Nohria","orcid":"0000-0002-7113-1118","position":11,"is_corresponding":false},{"id":412,"name":"Ryan J. Sullivan","orcid":"0000-0001-5344-6645","position":12,"is_corresponding":false},{"id":105169,"name":"Kerry L. Reynolds","orcid":"0000-0002-7793-654X","position":13,"is_corresponding":false},{"id":232171,"name":"Daniel A. Zlotoff","orcid":"0000-0001-9007-7295","position":14,"is_corresponding":false},{"id":232198,"name":"Tomas G. Neilan","orcid":"0000-0002-1513-8833","position":15,"is_corresponding":false},{"id":292885,"name":"Jingyi Gong","orcid":"0000-0001-7848-1084","position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T23:43:11.293086Z","pmid":"34145031","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}