| Autor: |
Kostine, Marie, Rouxel, Léa, Barnetche, Thomas, Veillon, Rémi, Martin, Florent, Dutriaux, Caroline, Dousset, Léa, Pham-Ledard, Anne, Prey, Sorilla, Beylot-Barry, Marie, Daste, Amaury, Gross-Goupil, Marine, Lallier, Julie, Ravaud, Alain, Forcade, Edouard, Bannwarth, Bernard, Truchetet, Marie-Elise, Richez, Christophe, Mehsen, Nadia, Schaeverbeke, Thierry |
| Předmět: |
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| Zdroj: |
Annals of the Rheumatic Diseases; Mar2018, Vol. 77 Issue 3, p393-398, 6p, 1 Diagram, 2 Charts |
| Abstrakt: |
Objectives: To evaluate the prevalence and type of rheumatic immune-related adverse events (irAEs) in patients receiving immune checkpoint inhibitors (ICIs), as well as the correlation with tumour response.Methods: This was a single-centre prospective observational study including all cancer patients receiving ICIs. The occurrence of irAEs and tumour response was assessed on a regular basis. Patients who experienced musculoskeletal symptoms were referred to the department of rheumatology for clinical evaluation and management.Results: From September 2015 to May 2017, 524 patients received ICIs and 35 were referred to the department of rheumatology (6.6%). All but one of the rheumatic irAEs occurred with anti-programmed cell death protein 1(PD-1)/PD-1 ligand 1(PD-L1) antibodies, with a median exposure time of 70 days. There were two distinct clinical presentations: (1) inflammatory arthritis (3.8%) mimicking either rheumatoid arthritis (n=7), polymyalgia rheumatica (n=11) or psoriatic arthritis (n=2) and (2) non-inflammatory musculoskeletal conditions (2.8%; n=15). One patient with rheumatoid arthritis was anti-cyclic citrullinated peptide (anti-CCP) positive. Nineteen patients required glucocorticoids, and methotrexate was started in two patients. Non-inflammatory disorders were managed with non-steroidal anti-inflammatory drugs, analgesics and/or physiotherapy. ICI treatment was pursued in all but one patient. Patients with rheumatic irAEs had a higher tumour response rate compared with patients without irAEs (85.7% vs 35.3%; P<0.0001).Conclusion: Since ICIs are used with increasing frequency, knowledge of rheumatic irAEs and their management is of major interest. All patients were responsive either to low-to-moderate doses of prednisone or symptomatic therapies and did not require ICI discontinuation. Furthermore, tumour response was significantly higher in patients who experienced rheumatic irAEs. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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