Tocilizumab in the treatment of steroid refractory immune-related hepatotoxicity: a case series and review of the literature
Articles > Article ยท 2024
Authors: Ahmet Anil Ozluk, Damla Gunenc, Saadet Sim Yildirim, Burcak Karaca
Melanoma Research, International, WoS, 2024, vol 34, pp 335-342
DOI: 10.1097/cmr.0000000000000969
Summary
With the widespread use of immune checkpoint inhibitors, management of immune-related adverse effects specific to these treatments became an important research era in patient management. Among these, immune-related hepatotoxicity (IRH) is an adverse event that can be fatal. While the first-line treatment of IRH is well established, there is still no consensus regarding the management approach for steroid-refractory, severe IRH. Here, we report four patients with metastatic melanoma who developed IRH during antiprogrammed cell death protein-1 plus anticytotoxic T-lymphocyte-associated protein-4 combination therapy and review of the literature. All of our patients were steroid-refractory and were successfully treated with tocilizumab. Given the rapid improvement in liver enzymes and patient's clinical status with tocilizumab, this treatment should be prioritized in steroid-refractory IRH.