Chikako Iwai, Taisuke Jo, Akira Okada, Asahi Fujita, Takaaki Konishi, Koji Oba, Yohei Hashimoto, Hideo Yasunaga
{"title":"Association between immune checkpoint inhibitors and uveitis in patients with lung cancer, renal cell carcinoma, or malignant melanoma.","authors":"Chikako Iwai, Taisuke Jo, Akira Okada, Asahi Fujita, Takaaki Konishi, Koji Oba, Yohei Hashimoto, Hideo Yasunaga","doi":"10.1016/j.jcjo.2025.02.010","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Immune checkpoint inhibitors (ICIs) reportedly have a potential risk of general ocular complications; however, whether ICIs have a risk of uveitis remains unclear. Therefore, we assessed whether ICI use has a higher risk of uveitis than chemotherapy alone.</p><p><strong>Methods: </strong>Using a large administrative claims database in Japan, we identified 26 474 patients with lung cancer, renal cell carcinoma, or malignant melanoma, who initiated ICI or chemotherapy between April 2014 and November 2022. The patients were divided into 2 groups: those receiving ICI with and without chemotherapy (ICI group: n = 8103) and those receiving chemotherapy alone (non-ICI group: n = 18 371). After propensity score-overlap weighting to adjust for background factors, we estimated the incidence of uveitis and performed Cox regression analyses. We also conducted subgroup analyses stratified by age (<75 and ≥75 years).</p><p><strong>Results: </strong>The overlap-weighted incidence of uveitis in the ICI group was higher than that in the non-ICI group (85.1 vs 55.9/10,000 person-years; number needed to harm: 343). The hazard ratio (HR) for uveitis in the ICI group was 1.49 (95% confidence interval, 1.11 to 2.01) in comparison with the non-ICI group. The age-stratified analysis showed that the ICI group had an increased risk among individuals aged <75 years (HR 1.65 [1.15 to 2.41]), while the risk did not differ among individuals aged ≥75 years (HR 1.35 [0.84 to 2.18]).</p><p><strong>Conclusions: </strong>ICI use was associated with a higher risk of uveitis compared to non-ICI use, particularly among patients aged <75 years.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jcjo.2025.02.010","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Immune checkpoint inhibitors (ICIs) reportedly have a potential risk of general ocular complications; however, whether ICIs have a risk of uveitis remains unclear. Therefore, we assessed whether ICI use has a higher risk of uveitis than chemotherapy alone.
Methods: Using a large administrative claims database in Japan, we identified 26 474 patients with lung cancer, renal cell carcinoma, or malignant melanoma, who initiated ICI or chemotherapy between April 2014 and November 2022. The patients were divided into 2 groups: those receiving ICI with and without chemotherapy (ICI group: n = 8103) and those receiving chemotherapy alone (non-ICI group: n = 18 371). After propensity score-overlap weighting to adjust for background factors, we estimated the incidence of uveitis and performed Cox regression analyses. We also conducted subgroup analyses stratified by age (<75 and ≥75 years).
Results: The overlap-weighted incidence of uveitis in the ICI group was higher than that in the non-ICI group (85.1 vs 55.9/10,000 person-years; number needed to harm: 343). The hazard ratio (HR) for uveitis in the ICI group was 1.49 (95% confidence interval, 1.11 to 2.01) in comparison with the non-ICI group. The age-stratified analysis showed that the ICI group had an increased risk among individuals aged <75 years (HR 1.65 [1.15 to 2.41]), while the risk did not differ among individuals aged ≥75 years (HR 1.35 [0.84 to 2.18]).
Conclusions: ICI use was associated with a higher risk of uveitis compared to non-ICI use, particularly among patients aged <75 years.
期刊介绍:
Official journal of the Canadian Ophthalmological Society.
The Canadian Journal of Ophthalmology (CJO) is the official journal of the Canadian Ophthalmological Society and is committed to timely publication of original, peer-reviewed ophthalmology and vision science articles.