[Rheumatic adverse events due to immune checkpoint inhibitors].
| Autor: | van Binsbergen WH; Amsterdam UMC, afd. Reumatologie en Klinische Immunologie, Amsterdam.; Contact: Wouter H. van Binsbergen (w.h.vanbinsbergen@amsterdamumc.nl)., Heslinga SC; Reade, Amsterdam., Lems WF; Amsterdam UMC, afd. Reumatologie en Klinische Immunologie, Amsterdam., Tsang-A-Sjoe MWP; Amsterdam UMC, afd. Reumatologie en Klinische Immunologie, Amsterdam., Labots M; Amsterdam UMC, afd. Medische Oncologie, Amsterdam., van der Laken J; Amsterdam UMC, afd. Reumatologie en Klinische Immunologie, Amsterdam. |
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| Jazyk: | Dutch; Flemish |
| Zdroj: | Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] 2023 Nov 01; Vol. 167. Date of Electronic Publication: 2023 Nov 01. |
| Abstrakt: | Background: Oncological survival and quality-of-life improved significantly after introduction of immune checkpoint inhibitors (ICIs). Immunotherapy, however, also decreases immunotolerance, potentially inducing autoimmune reactions. This can result in symptoms mimicking rheumatic diseases. Case Description: Patient A, 51-years-old, female, was treated with adjuvant nivolumab for metastatic melanoma. After 9 months, she developed arthritis. Prednisone 30 mg/ day and methotrexate significantly improved arthritis, followed by prednisone tapering. Patient B, 75-year-old, male with metastatic melanoma treated with Ipilimumab/Nivolumab developed malaise and reduced muscle strength shortly after treatment start. Patient was suspected of myositis/myocarditis, treated with methylprednisolone, which resulted in a rapid improvement. Conclusion: ICIs can cause rheumatic adverse events, resulting in decreased quality of life that may require immunesuppressive treatment. Disruption or cessation of ICIs may occur. These adverse events demand low-threshold rheumatological referral and collaboration between oncologist and rheumatologist. Further research must indicate the most effective immunosuppressive therapies with minimized negative oncological impact. |
| Databáze: | MEDLINE |
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