{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:05:04Z","timestamp":1788822304185,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T00:00:00Z","timestamp":1712188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To detect immune\u2010related adverse events (irAEs) early and treat them appropriately, our institute established an irAE\u2010focused multidisciplinary toxicity team in cooperation with various departments. This study aimed to evaluate a consultation system involving a team of hepatologists in terms of its utility for the management of severe immune checkpoint inhibitor (ICI)\u2010induced liver toxicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To analyze the diagnosis and treatment of severe ICI\u2010induced liver toxicity (Grade 2 requiring corticosteroid therapy and Grade 3 or higher), we examined patients' clinical courses before and after the hepatologist consultation system was established (pre\u2010period, September 2014 to February 2019; post\u2010period, March 2019 to March 2023).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median follow\u2010up period was 392\u00a0days. Of the 1247 patients with advanced malignancies treated with ICIs, 66 developed severe ICI\u2010induced liver toxicity (<jats:italic>n<\/jats:italic>\u00a0=\u00a022 and 44 in the pre\u2010 and post\u2010periods, respectively). In the pre\u2010period, hepatologist consultations were sought for 15\/22 patients, whereas in the post\u2010period, 42\/44 patients were referred to and treated by hepatologists. The time from the onset of liver toxicity to the consultation was significantly shorter in the post\u2010period than in the pre\u2010period (mean 1.9 vs. 6.5\u00a0days, respectively; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.012). The number of patients with a biopsy\u2010confirmed diagnosis of ICI\u2010induced liver toxicity was significantly higher in the post\u2010period than in the pre\u2010period (<jats:italic>n<\/jats:italic>\u00a0=\u00a022 vs. <jats:italic>n<\/jats:italic>\u00a0=\u00a03, respectively; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.006). Finally, there were no cases of immune\u2010related cholangitis in the pre\u2010period, compared to five cases in the post\u2010period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A hepatologist consultation system in an irAE\u2010focused multidisciplinary toxicity team is useful for managing severe ICI\u2010induced liver toxicity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.14043","type":"journal-article","created":{"date-parts":[[2024,4,4]],"date-time":"2024-04-04T07:39:46Z","timestamp":1712216386000},"page":"1060-1069","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Outcomes of immune checkpoint inhibitor\u2010induced liver toxicity managed by hepatologists in a multidisciplinary toxicity team"],"prefix":"10.1111","volume":"54","author":[{"given":"Takanori","family":"Ito","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagoya University Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyuki","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagoya University Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9904-1894","authenticated-orcid":false,"given":"Takafumi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagoya University Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsukasa","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagoya University Hospital  Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Nagoya University Hospital 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