Immune checkpoint inhibitors-associated vasculitis: a heterogeneous condition with possible severe disease course.

Autor:	Chanson N; AP-HP, Université Paris Saclay, department of internal medicine and clinical immunology, Bicêtre Hospital, Le Kremlin Bicêtre, France., Galvagni A; AP-HP, Université Paris Saclay, department of internal medicine and clinical immunology, Bicêtre Hospital, Le Kremlin Bicêtre, France., Ramos-Casals M; Department of Autoimmune Diseases, ICMiD, Hospital Clinic, Barcelona, Spain.; Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Barcelona, Spain.; Department of Medicine, University of Barcelona, Barcelona, Spain., Ruiz JI; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Pm Suijkerbuijk K; Department of Medical Oncology, UMC Utrecht Cancer Center, Utrecht University, Utrecht, the Netherlands., Benesova K; Department of Internal Medicine and Rheumatology, Universitätsklinikum Heidelberg, Germany., Kerschen P; Service de Neurologie, Centre Hospitalier de Luxembourg, Luxembourg-Ville, Luxembourg., Karam JD; Internal Medicine and RECIF, CHU Amiens Picardie, Amiens, France., Belkhir R; AP-HP, Université Paris Saclay, department of rheumatology, Bicêtre Hospital, Le Kremlin Bicêtre, France., Outh R; Service de Médecine interne et générale, Centre Hospitalier de Perpignan, Perpignan, France., Closs-Prophette F; Médecine Polyvalente, Centre Hospitalier du Mans, France., Morillo JSG; Department of Internal Medicine, Universitario Hospital Virgen Del Rocio, Sevilla, Spain., Robles-Marhuenda Á; Internal Medicine Department, Hospital universitario La Paz, Madrid, Spain., Michot JM; Departement D'Innovation Therapeutique et D'Essais Precoces, Institut Gustave Roussy, Universite Paris-Saclay, Villejuif, F-94805, France., Voisin AL; Departement D'Innovation Therapeutique et D'Essais Precoces, Institut Gustave Roussy, Universite Paris-Saclay, Villejuif, F-94805, France., Messayke S; Departement D'Innovation Therapeutique et D'Essais Precoces, Institut Gustave Roussy, Universite Paris-Saclay, Villejuif, F-94805, France., Laparra A; DIOPP, Institut Gustave Roussy, Universite Paris-Saclay, Villejuif, F-94805, France., Robert C; Department of Dermatology, Institut Gustave Roussy, University Paris-Saclay, Villejuif, F-94805, France., Suarez-Almazor M; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA., Mariette X; AP-HP, Université Paris Saclay, department of rheumatology, Bicêtre Hospital, Le Kremlin Bicêtre, France.; University Paris-Saclay; INSERM; CEA, Centre Immunology of Viral Infections and Autoimmune Diseases, IDMIT, UMR1184, Department IBFJ, Le Kremlin-Bicêtre, France., Lambotte O; AP-HP, Université Paris Saclay, department of internal medicine and clinical immunology, Bicêtre Hospital, Le Kremlin Bicêtre, France.; University Paris-Saclay; INSERM; CEA, Centre Immunology of Viral Infections and Autoimmune Diseases, IDMIT, UMR1184, Department IBFJ, Le Kremlin-Bicêtre, France.
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2024 Dec 23. Date of Electronic Publication: 2024 Dec 23.
DOI:	10.1093/rheumatology/keae711
Abstrakt:	Objective: To describe presentation, treatment and outcome of immune checkpoint inhibitor (ICI) associated-vasculitis in cancer patients in a multicentre study. Methods: Thanks to the ImmunoCancer International Registry (ICIR), a multidisciplinary network focused on the research of the immune related adverse events related to cancer immunotherapies, patients presenting with a clinical and/or radiological suspicion of vasculitis, and histological evidence of vasculitis after being exposed to ICIs were retrospectively identified. Results: Twenty eight cases were identified in the ICIR registry. The median interval between starting ICI treatment and vasculitis diagnosis was 4 months. Small vessel vasculitis were predominant (n = 21), followed by large vessel (n = 4) and medium vessel (n = 3). The small vessel vasculitis included 10 unclassified vasculitis either with limited cutaneous involvement (n = 6) or systemic involvement (n = 4), 5 IgA vasculitis, 3 cryoglobulinemic vasculitis, and 3 ANCA+ vasculitis. At presentation or during the evolution, renal and neurologic manifestations were evidenced in 7 cases each (25%). Renal biopsies documented immune glomerulopathies in 6 cases. Only seven patients (25%) fulfilled the 2022 ACR/EULAR classification criteria (4 giant cell arteritis, 2 EGPA, and one GPA). Most patients (90%) required systemic corticosteroid and an additional drug was given in 10 patients (36%). Vasculitis outcome was good: 22 patients had vasculitis complete response, no patient died due to vasculitis. Nine patients (32%) were rechallenged with immunotherapy with only one relapse. Conclusion: ICI-associated vasculitis are rare, heterogeneous, but can be severe requiring urgent multidisciplinary management with aggressive treatment. (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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