ILD ups risks of pneumonitis, mortality in patients taking ICIs

Among patients receiving immune checkpoint inhibitors (ICIs), those with interstitial lung disease (ILD) have a significantly greater risk of developing checkpoint inhibitor pneumonitis (CIP) and may experience worse outcomes, including recurrence and death, reveals a study.

Researchers conducted this retrospective cohort study and identified patients who received ICIs between January 2017 and January 2023 using the TriNetX Research Network. They stratified patients into ILD, chronic obstructive pulmonary disease (COPD), and control groups.

CIP was identified via ICD codes. Baseline characteristics were adjusted using propensity score matching. Finally, outcomes assessed were CIP incidence, time to onset, hospitalization, recurrence, and mortality.

A total of 184,000 patients received ICI. Of these, 3,147 had ILD, 8,657 had COPD, and 47,031 had no known lung disease. After propensity score matching (n=3,147 per group), ILD patients showed the highest CIP incidence relative to COPD patients and controls (4.6 percent vs 1.9 percent and 1.5 percent; p<0.001). Time to CIP onset did not significantly differ across groups.

Furthermore, ILD patients with CIP were more likely to experience recurrence (16.4 percent vs 9.1 percent and 8.3 percent) and all-cause hospitalization (61 percent vs 40 percent and 39 percent) than COPD patients and controls. All-cause mortality was also greater in those with ILD and CIP (41.1 percent).

“These findings support closer surveillance and risk stratification in ICI-treated patients with underlying ILD,” the researchers said.

CIP is a serious immune-related adverse event, according to the researchers.