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Immune related adverse events associated with anti-CTLA-4 antibodies: systematic review and meta-analysis

Overview of attention for article published in BMC Medicine, September 2015
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (84th percentile)

Mentioned by

1 news outlet
7 tweeters


482 Dimensions

Readers on

486 Mendeley
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Immune related adverse events associated with anti-CTLA-4 antibodies: systematic review and meta-analysis
Published in
BMC Medicine, September 2015
DOI 10.1186/s12916-015-0455-8
Pubmed ID

Anne Bertrand, Marie Kostine, Thomas Barnetche, Marie-Elise Truchetet, Thierry Schaeverbeke


Targeting CTLA-4 is a recent strategic approach in cancer control: blocking CTLA-4 enhances an antitumor immunity by promoting T-cell activation and cytotoxic T-lymphocyte proliferation. This induction of a tolerance break against the tumor may be responsible for immune-related adverse events (irAEs). Our objective was to assess the incidence and nature of irAEs in oncologic patients receiving anti-CTLA-4 antibodies (ipilimumab and tremelimumab). A systematic search of literature up to February 2014 was performed in MEDLINE, EMBASE, and Cochrane databases to identify relevant articles. Paired reviewers independently selected articles for inclusion and extracted data. Pooled incidence was calculated using R(©), package meta. Overall, 81 articles were included in the study, with a total of 1265 patients from 22 clinical trials included in the meta-analysis. Described irAEs consisted of skin lesions (rash, pruritus, and vitiligo), colitis, and less frequently hepatitis, hypophysitis, thyroiditis, and some rare events such as sarcoidosis, uveitis, Guillain-Barré syndrome, immune-mediated cytopenia and polymyalgia rheumatic/Horton. The overall incidence of all-grade irAEs was 72 % (95 % CI, 65-79 %). The overall incidence of high-grade irAEs was 24 % (95 % CI, 18-30 %). The risk of developing irAEs was dependent of dosage, with incidence of all-grade irAEs being evaluated to 61 % (95 % CI, 56-66 %) for ipilimumab 3 mg/kg and 79 % (95 % CI, 69-89 %) for ipilimumab 10 mg/kg. Death due to irAEs occurred in 0.86 % of patients. The median time of onset of irAEs was about 10 weeks (IQR, 6-12) after the onset of treatment, corresponding with the first three cycles but varied according to the organ system involved. Such immune activation could also be indicative for tumor-specific T-cell activation and irAE occurrence was associated with clinical response to CTLA-4 blocking in 60 % of patients. The price of potential long-term survival to metastatic tumors is an atypical immune toxicity, reflecting the mechanism of action of anti-CTLA-4 antibodies. A better knowledge of these irAEs and its management in a multidisciplinary approach will help to reduce morbidity and therapy interruptions.

Twitter Demographics

The data shown below were collected from the profiles of 7 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 486 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
United States 1 <1%
Unknown 484 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 76 16%
Student > Bachelor 65 13%
Student > Ph. D. Student 46 9%
Student > Master 46 9%
Other 45 9%
Other 120 25%
Unknown 88 18%
Readers by discipline Count As %
Medicine and Dentistry 222 46%
Agricultural and Biological Sciences 40 8%
Biochemistry, Genetics and Molecular Biology 28 6%
Immunology and Microbiology 26 5%
Pharmacology, Toxicology and Pharmaceutical Science 19 4%
Other 46 9%
Unknown 105 22%

Attention Score in Context

This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 August 2021.
All research outputs
of 21,798,458 outputs
Outputs from BMC Medicine
of 3,190 outputs
Outputs of similar age
of 254,585 outputs
Outputs of similar age from BMC Medicine
of 1 outputs
Altmetric has tracked 21,798,458 research outputs across all sources so far. Compared to these this one has done well and is in the 86th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,190 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 42.6. This one is in the 47th percentile – i.e., 47% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 254,585 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 84% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them