SAT0540 ONE-YEAR OUTCOMES AFTER RHEUMATIC IMMUNE-RELATED ADVERSE EVENTS FROM CHECKPOINT INHIBITORS
| Autor: | E. Berard, Sorilla Prey, Caroline Dutriaux, Alain Ravaud, R. Veillon, Léa Dousset, Léa Rouxel, Charlotte Vergnenegre, Julien Seneschal, Amaury Daste, Marie Beylot-Barry, Baptiste Sionneau, T. Schaeverbeke, Charlotte Domblides, Edouard Forcade, Thomas Barnetche, Marine Gross-Goupil, Marie Kostine |
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| Rok vydání: | 2020 |
| Předmět: |
030203 arthritis & rheumatology
0301 basic medicine medicine.medical_specialty business.industry medicine.medical_treatment Inflammatory arthritis Immunology Cancer Immunotherapy medicine.disease General Biochemistry Genetics and Molecular Biology Immune checkpoint Polymyalgia rheumatica 03 medical and health sciences Psoriatic arthritis 030104 developmental biology 0302 clinical medicine Rheumatology Rheumatoid arthritis Internal medicine medicine Immunology and Allergy business Adverse effect |
| Zdroj: | Annals of the Rheumatic Diseases. 79:1227.2-1227 |
| ISSN: | 1468-2060 0003-4967 |
| DOI: | 10.1136/annrheumdis-2020-eular.4366 |
| Popis: | Background:Description and initial management of rheumatic immune-related adverse-events (irAEs) from cancer immunotherapies have been reported by several groups but to date, few studies have evaluated the long-term outcomes and management of rheumatic irAEs (1).Objectives:To describe the long-term management and assess the one-year outcomes of patients who experienced rheumatic immune-related adverse events (irAEs) due to immune checkpoint inhibitors (ICI).Methods:This was a single-centre prospective observational study including patients referred for musculoskeletal symptoms while treated with ICI. After baseline rheumatological evaluation defining the clinical entity presented, follow-up visits were organised according to the type and severity of irAE. At one year, persistence of irAE, ongoing treatment, as well as cancer outcomes were assessed.Results:63 patients were included between September 2015 and June 2018. 24 patients (38%) presented with non-inflammatory musculoskeletal conditions managed with short-term symptomatic treatment and did not require specific follow-up. 39 patients (62%) experienced inflammatory manifestations, mimicking either rheumatoid arthritis (RA, n=19), polymyalgia rheumatica (PMR, n=16), psoriatic arthritis (PsA, n=3) and one flare of a preexisting axial spondyloarthritis. Overall, 32 patients (82%) received systemic glucocorticoids, with a median rheumatic dosage of 15mg/day (range: 5-60mg/day). None of the patients had to permanently discontinue ICI therapy for rheumatic irAE. 20 patients (67%) were still receiving glucocorticoids at one year, with a median dosage of 5mg/day (range: 2-20mg/day). Glucocorticoids were more frequently discontinued for patients with RA-like condition (44%) than PMR-like condition (23%), but no other predictive factor of glucocorticoids withdrawal could be identified. At one year, overall survival and progression-free survival were comparable between patients who were still receiving glucocorticoids for rheumatic irAE and patients who have discontinued. Eight patients required csDMARDs.Conclusion:At one year, a majority of patients required long-term low-dose glucocorticoids for chronic rheumatic irAE, which seems not altering oncological control.References:[1]Braaten TJ, Brahmer JR, Forde PM, et al. Immune checkpoint inhibitor-induced inflammatory arthritis persists after immunotherapy cessation. Ann Rheum Dis. 2019 Sep 20.Disclosure of Interests:None declared |
| Databáze: | OpenAIRE |
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