Pulmonary vascular disease & thromboembolism

Early Change in C-Reactive Protein and Venous Thromboembolism in Patients Treated With Immune Checkpoint Inhibitors

JACC CardioOncolPublished Retrospective cohort study

Main finding · Cumulative VTE incidence, discovery cohortResult — go to the resultSubdistribution hazard ratio 2.64 95% CI 1.06–6.62

Authors' conclusion

Early CRP changes during ICI therapy are associated with an increased risk of VTE, suggesting a potential association between ICI-induced inflammation and hypercoagulability.

Study context

Population
Patients with cancer initiating immune checkpoint inhibitor therapydiscovery 405, validation 417
Participants
822 patients
Exposure
C-reactive protein (CRP) rise vs no CRP rise during first 3 months of ICI therapy
Outcome
Venous thromboembolism (VTE)
Follow-up
Duration of ICI therapy
Methodological details2 academic cancer centres, discovery and external validation cohorts, competing risk and time-dependent analyses
  • 2 academic cancer centres
  • Discovery and external validation cohorts
  • Competing risk and time-dependent analyses

Main finding

Cumulative VTE incidence, discovery cohort

Subdistribution hazard ratio

2.64

95% CI 1.06–6.62

By group

CRP rise vs No CRP rise
subdistribution HR 2.64 (95% CI 1.06–6.62)

As reported in the abstract

Observational data: associations, not effects.

Further findings

OutcomeCRP riseNo CRP riseSubdistribution HR (95% CI)
VTE, external validation cohort · validation cohort (n = 417)22.9% (95% CI 9.7%–39.3%)10.8% (95% CI 7.4%–15.1%)2.25 (1.03–4.94)

Time-dependent analysis

Association confirmed in time-dependent analysis; consistent after adjusting for disease progression

Original publication

Early Change in C-Reactive Protein and Venous Thromboembolism in Patients Treated With Immune Checkpoint Inhibitors. JACC CardioOncol. Published 12 November 2024. doi:10.1016/j.jaccao.2024.09.007

Summarised from the published abstract; every number is checked against it

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