Pulmonary vascular disease & thromboembolismCohort study
Early Change in C-Reactive Protein and Venous Thromboembolism in Patients Treated With Immune Checkpoint Inhibitors
- Retrospective cohort study
- 2 academic cancer centres
- discovery and external validation cohorts
- competing risk and time-dependent analyses
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
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
| Outcome | CRP rise | No CRP rise | subdistribution 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) | |
| 0.20.5125Subdistribution hazard ratio (log scale) |
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