222eP Severe immune-related adverse events with checkpoint inhibitors: A single-center experience with implications for practice

Methods: This retrospective study included patients who experienced irAEs from 5 tertiary hospitals in China between January 2018 and December 2024.Patients were divided into Group A (MgIG+GCs) and Group B (GCs alone).Propensity score matching (PSM) was used to balance baseline confounders (gender, age, toxicity types, and baseline irAEs grade as control variables).Primary endpoint was irAEs clinical cure rate (reduction to Grade 0).Secondary endpoints were irAEs grade change, magnitude of irAEs reduction, GCs dose, and GCs duration.Wilcoxon ranksum test, chi-square test/Fisher's exact test, and multivariate Logistic regression were applied as appropriate for statistical analyses.Results: A total of 1039 patients were enrolled (Group A: 455; Group B: 584), with 436 matched pairs after PSM.Group A had a significantly higher clinical cure rate than Group B (67.43% vs 60.09%, P=0.024).The median change in irAEs grade was -1 (interquartile range [IQR]: -2 to -1) in Group A versus -1 (IQR: -1 to -1) in Group B (P<0.001).The proportions of patients with a reduction of 2 and 3 grades of irAEs were higher in Group A than Group B (P<0.001).Group A had lower GC exposure than group B: median average GC dose (0.62 mg/kgd vs 0.68 mg/kgd, P=0.012), and median GC duration (4 days vs 5 days, P<0.001).In multivariate analysis, MgIG +GCs was an independent protective factor for irAEs clinical cure (odds ratio=1.514,P<0.05).Conclusions: MgIG combined with GCs significantly improves irAEs clinical cure rates while reducing GC dose and duration.This regimen provides an effective strategy for managing irAEs in patients receiving ICI treatment.