Students Research in Progress
Tuesday, October 15, 2024
08:30 AM–10:00 AM
Abstract
Introduction:
Immune checkpoint inhibitors (ICIs) have been associated with various cardiovascular toxicities, including pericarditis. Unlike other cardiotoxicities, ICI-induced pericarditis is less well-characterized and thus, its clinical meaningfulness is not well understood.
Research Question or Hypothesis: The objective of our case series is to understand clinical presentation, risk factors, management, and complications associated with ICI-induced pericarditis.
Study Design: This is a retrospective, single-center case series.
Methods: Following Institutional Review Board approval, five patients receiving an ICI with an ICD-9/-10 code for pericarditis from April 1, 2014 to June 15, 2024 were identified. Patients were excluded if age <18 years, pregnancy, or pericarditis preceding ICI administration. Clinical characteristics, pericarditis management, and outcomes were collected. REDCap was utilized for data collection and descriptive analysis.
Results: To date, data on five cases with documented ICI-induced pericarditis are available. Median age was 64 years (range: 43-72), 60% male, 40% white, 60% black and all non-Hispanic. Four cases were acute and one case was recurrent. Cancer types varied (two lung cancer; one each of breast, urothelial and salivary cancer). ICIs administered included pembrolizumab (n=4) or avelumab (n=1). Chest pain and dyspnea were the most common presenting symptoms (80% each), and other symptoms included cough, fatigue, and fever. Median time to onset of pericarditis from ICI initiation was 90 days (range: 8-269). Four patients received treatment for their pericarditis including ibuprofen (n=2), ketorolac (n=1), colchicine (n=2) or methylprednisolone (n=1). Median time to pericarditis resolution was 15 days (range: 4-43). One patient received subsequent ICI doses with only one week delay before initiation and no recurrence of pericarditis.
Conclusion: Additional cases will provide a better understanding of the impact of ICI-induced pericarditis on cancer care, including if a national registry may be warranted.
Presenting Author
Christian Palumbo PharmD CandidateUniversity of North Carolina at Chapel Hill
Authors
Sarah Kaspari PharmD
UNC Eshelman School of Pharmacy
Chloe Kim PharmD
University of North Carolina at Chapel Hill
Emily Ong PharmD Candidate
University of North Carolina at Chapel Hill
Kristina Paramore PharmD, MPH
UNC Eshelman School of Pharmacy
Kaitlyn Paxton PharmD, MBA
UNC Eshelman School of Pharmacy
Jo E. Rodgers PharmD, FCCP, BCPS-AQ Cardiology
Eshelman School of Pharmacy, University of North Carolina
Hannah Summers PharmD Candidate
University of North Carolina at Chapel Hill
Zijie Zhang PharmD Candidate
University of North Carolina at Chapel Hill