ORIGINAL RESEARCH article
Front. Oncol.
Sec. Pharmacology of Anti-Cancer Drugs
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1621045
This article is part of the Research TopicDecoding the immunotherapy paradox: integrative approaches for balancing efficacy and immunotherapy-associated adverse eventsView all 3 articles
Immune checkpoint inhibitor-associated autoimmune encephalitis and other neurological immune-mediated adverse events: A Pharmacovigilance study using the FAERS and JADER
Provisionally accepted
- Beijing Tongren Hospital, Beijing, China
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Background: Immune checkpoint inhibitor (ICI)-associated neurological immune-related adverse events (NAEs) are rare but serious side effects, of which autoimmune encephalitis (AIE) is a potentially fatal central nervous system disorder requiring more attention.Methods: We performed a retrospective disproportionality analysis of NAE reports in the FDA Adverse Event Reporting System (FAERS) and the Japanese Adverse Event Reporting Database (JADER) from 2004 to 2024, utilizing reporting odds ratio (ROR), proportional reporting ratio (PRR), the Bayesian confidence propagation neural network BCPNN, and the multi-item gamma Poisson shrinker (MGPS) for signal detection.Results: In total, 3,999 reports of ICI-associated NAEs were identified from the FAERS database, of which 1,998 reports were AIE. 1,558,251 reports of AEs were collected from the JADER database, which contained 890 AIE reports. ICIs, including pembrolizumab, nivolumab, atezolizumab, ipilimumab, and durvalumab, were identified among the top 30 agents in both databases, demonstrating significant signals across all 4 algorithms. Except for noninfectious myelitis, acute disseminated encephalomyelitis, and multiple sclerosis, positive signals were detected in all other preferred terms (PTs). These NAEs accounted for 23.7% of total mortality, with myasthenia gravis (MG) exhibiting the highest mortality rate at 30.63%. Specific PTs, such as aseptic meningitis, AIE, chronic inflammatory demyelinating polyradiculoneuropathy, Guillain-Barré syndrome, MG, myelitis, and immune-related myopathy, were associated with the severity of outcomes, showing significant statistical differences between severe and non-severe cases (p < 0.05).Conclusion: Our study found a notable correlation between ICIs and AIE and other specific NAEs, highlighting the demographic characteristics, time to onset, and disease severity of ICI-induced NAEs, thereby facilitating the timely recognition and treatment of these ICI therapy-related complications.
Keywords: Immune checkpoint inhibitor, autoimmune encephalitis, Immune-related adverse events, Pharmacovigilance, FAERS
Received: 30 Apr 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 Di, Shi, Gai and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiawei Wang, Beijing Tongren Hospital, Beijing, China
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