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Research Article: Analysis of the twelve cases of immune-related myocarditis caused by cadonilimab

Date Published: 2025-10-17

Abstract:
This study aims to analyze the clinical characteristics of immune-related myocarditis caused by cadonilimab, thereby providing a reference for its safe clinical application. A retrospective analysis was conducted on the medical records of 12 patients diagnosed with immune-related myocarditis caused by cadonilimab at our hospital between January 1st, 2021 and December 31, 2024. The incidence of immune-related myocarditis caused by cadonilimab was 2.45% (95%CI:1.30%-4.20%). Among the 12 patients who developed immune-related myocarditis, the majority were female (66.7%) and aged 65 years or younger (83.33%). The median time to onset was 49 days(IQR 27.75, 78), with 10 cases occurring within 90 days following the initial administration. 7 patients were off-label use. Additionally, 7 patients were accompanied by other immune checkpoint inhibitor (ICI)-related adverse events (irAEs), such as hypothyroidism, hepatitis and infusion reactions. 9 patients received glucocorticoid treatment and all of the 12 patients showed improvement and recovery. The clinical use of cadonilimab is complex, necessitating individualized monitoring for immune-related myocarditis based on the patient’s condition. Furthermore, patient education is essential to ensure medication safety.

Introduction:
Cadonilimab, recognized as the first bispecific antibody globally, targets the programmed cell death receptor-1 (PD-1) and cytotoxic T-lymphocyte-associated protein-4 (CTLA-4). It has received approval from the National Medical Products Administration (NMPA) in China for the treatment of patients with recurrent or metastatic cervical cancer who have experienced failure with prior platinum-based chemotherapy. Additionally, it is approved for patients with persistent, recurrent, or metastatic cervical cancer…

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