Journal ArticleDOI
Rheumatoid arthritis and polymyalgia rheumatica occurring after immune checkpoint inhibitor treatment.
Rakiba Belkhir,Sébastien Le Burel,Laetitia Dunogeant,Aurélien Marabelle,Antoine Hollebecque,Benjamin Besse,Alexandra Leary,Anne-Laure Voisin,Clémence Pontoizeau,Laetitia Coutte,Edouard Pertuiset,Gaël Mouterde,Olivier Fain,Olivier Lambotte,Xavier Mariette,Xavier Mariette +15 more
TLDR
Cases of rheumatoid arthritis (RA) and polymyalgia rheumatica (PMR) occurring after ICI treatment for cancer are reported, the first description of RA occurring afterICI therapy for cancer.Abstract:
Objectives Immune checkpoint inhibitors (ICIs) targeting cytotoxic T-lymphocyte-associated protein 4 and programmed cell death protein 1 (PD-1) have demonstrated improved survival for multiple cancers. However, these new drug classes have led to increased immune-related adverse events (IrAE). Rheumatic IrAEs have not been well described in clinical trials. We report here cases of rheumatoid arthritis (RA) and polymyalgia rheumatica (PMR) occurring after ICI treatment. Methods This was a retrospective study of patients receiving an ICI in whom symptoms of arthritis or arthralgia developed and revealed a diagnosis of RA or PMR. Results In 10 patients who received ICI therapy (all anti-PD-1 or anti-PDL1 antibodies), RA or PMR developed at a median of 1 month (1 to 9) after exposure. No patient had pre-existing rheumatic or autoimmune disease. RA developed in six patients; all six were positive for anti-cyclic citrullinated peptide (anti-CCP) antibodies and four for rheumatoid factor. Anti-CCP antibodies were detected in two out of three patients tested before immunotherapy. Disease-modifying antirheumatic drugs were needed for three patients; the three others received corticosteroids or non-steroid anti-inflammatory drugs. PMR was diagnosed in four patients, all responded to corticosteroids. Despite these IrAEs, immunotherapy was pursued for all but one patient until cancer progression. Conclusions This is the first description of RA occurring after ICI therapy for cancer. PMR can also occur after ICI, particularly after anti-PD-1 therapy. All cases responded to corticosteroids or with immunosuppressive therapy. Collaboration between rheumatologists and oncologists is crucial and could lead to better recognition and care of these patients.read more
Citations
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Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: American Society of Clinical Oncology Clinical Practice Guideline
Julie R. Brahmer,Christina Lacchetti,Bryan J. Schneider,Michael B. Atkins,Kelly J. Brassil,Jeffrey M. Caterino,Ian Chau,Marc S. Ernstoff,Jennifer M. Gardner,Pamela K. Ginex,Sigrun Hallmeyer,Jennifer Holter Chakrabarty,Natasha B. Leighl,Jennifer S. Mammen,David F. McDermott,Aung Naing,Loretta J. Nastoupil,Tanyanika Phillips,Laura Diane Porter,Igor Puzanov,Cristina A. Reichner,Bianca Santomasso,Carole Seigel,Alexander Spira,Maria E. Suarez-Almazor,Yinghong Wang,Jeffrey S. Weber,Jeffrey S. Weber,Jedd D. Wolchok,John A. Thompson +29 more
TL;DR: Recommendations for specific organ system-based toxicity diagnosis and management are presented and, in general, permanent discontinuation of ICPis is recommended with grade 4 toxicities, with the exception of endocrinopathies that have been controlled by hormone replacement.
Journal ArticleDOI
Management of Immunotherapy-Related Toxicities, Version 1.2019.
John A. Thompson,Bryan J. Schneider,Julie R. Brahmer,Stephanie Andrews,Philippe Armand,Shailender Bhatia,Lihua E. Budde,Luciano J. Costa,Marianne Davies,David Dunnington,Marc S. Ernstoff,Matthew J. Frigault,Brianna Hoffner,Christopher J. Hoimes,Mario E. Lacouture,Frederick L. Locke,Matthew A. Lunning,Nisha Mohindra,Jarushka Naidoo,Anthony J. Olszanski,Olalekan O. Oluwole,Sandip Pravin Patel,Sunil Reddy,Mabel Ryder,Bianca Santomasso,Scott Shofer,Jeffrey A. Sosman,Momen M. Wahidi,Yinghong Wang,Alyse Johnson-Chilla,Jillian L. Scavone +30 more
TL;DR: The content featured in this issue is an excerpt of the recommendations for managing toxicity related to immune checkpoint blockade and a review of existing evidence.
Journal ArticleDOI
Immune-related adverse events for anti-PD-1 and anti-PD-L1 drugs: systematic review and meta-analysis
Shrujal S. Baxi,Shrujal S. Baxi,Annie Yang,Renee L. Gennarelli,Niloufer Khan,Ziwei Wang,Lindsay M. Boyce,Deborah Korenstein +7 more
TL;DR: Organ specific immune-related adverse events are uncommon with anti-PD-1 drugs but the risk is increased compared with control treatments, and general adverse events related to immune activation are largely similar.
Journal ArticleDOI
Management of Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy: ASCO Guideline Update.
Bryan J. Schneider,Jarushka Naidoo,Bianca Santomasso,Christina Lacchetti,Sherry Adkins,Milan J. Anadkat,Michael B. Atkins,Kelly J. Brassil,Jeffrey M. Caterino,Ian Chau,Marianne Davies,M. S. Ernstoff,Leslie A. Fecher,Monalisa Ghosh,Ishmael Jaiyesimi,Jennifer S. Mammen,Aung Naing,Loretta J. Nastoupil,Tanyanika Phillips,Laura Diane Porter,Cristina A. Reichner,Carole Seigel,Jung-Min Song,Alexander I. Spira,Maria E. Suarez-Almazor,Umang Swami,John A. Thompson,Praveen Vikas,Yinghong Wang,Jeffrey S. Weber,Pauline Funchain,Kathryn Bollin +31 more
TL;DR: In this article, the recommended management of immune-related adverse events (irAEs) in patients treated with immune checkpoint inhibitor (ICP) was discussed. But, the authors did not provide guidance on recommended management.
Journal ArticleDOI
Rheumatic disorders associated with immune checkpoint inhibitors in patients with cancer—clinical aspects and relationship with tumour response: a single-centre prospective cohort study
Marie Kostine,Léa Rouxel,Thomas Barnetche,R. Veillon,Florent Martin,Caroline Dutriaux,Léa Dousset,Anne Pham-Ledard,Sorilla Prey,Marie Beylot-Barry,Amaury Daste,Marine Gross-Goupil,Julie Lallier,Alain Ravaud,Edouard Forcade,Bernard Bannwarth,Marie-Elise Truchetet,Christophe Richez,Nadia Mehsen,Thierry Schaeverbeke +19 more
TL;DR: Tumour response was significantly higher in patients who experienced rheumatic irAEs and their management is of major interest, since ICIs are used with increasing frequency.
References
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2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative.
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TL;DR: This new classification system redefines the current paradigm of RA by focusing on features at earlier stages of disease that are associated with persistent and/or erosive disease, rather than defining the disease by its late-stage features.
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Development of lupus-like autoimmune diseases by disruption of the PD-1 gene encoding an ITIM motif-carrying immunoreceptor.
TL;DR: It is suggested that PD-1 is involved in the maintenance of peripheral self-tolerance by serving as a negative regulator of immune responses in lymphocytes and monocytic cells following activation.
Journal ArticleDOI
Specific autoantibodies precede the symptoms of rheumatoid arthritis: A study of serial measurements in blood donors
M M J Nielen,Dirkjan van Schaardenburg,Henk W. Reesink,Rob J. Van De Stadt,Irene E. van der Horst-Bruinsma,Margret H. M. T. De Koning,Moud R. Habibuw,Jan P. Vandenbroucke,Ben A. C. Dijkmans +8 more
TL;DR: In this article, the authors investigated the time course for the development of antibodies before onset of clinical RA and found that approximately half of patients with RA have specific serologic abnormalities several years before the onset of symptoms.
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