Musculoskeletal immune-related adverse events in 927 patients treated with immune checkpoint inhibitors for solid cancer - 15/01/23
Highlights |
• | The prevalence of musculoskeletal irAEs was 12.7%. |
• | Inflammatory rheumatic features accounted for 30.5% of all musculoskeletal irAEs. |
• | Systemic corticosteroids were used in 32.2% of all patients. |
• | The majority of musculoskeletal irAEs resolved. |
• | Tumor response did not differ according to irAE severity or type of musculoskeletal manifestations. |
Abstract |
Objective |
The prevalence of the musculoskeletal immune-related adverse events (irAEs) is probably underestimated, as most studies report only severe side effects. Our aim was to describe and characterize all musculoskeletal irAEs in a large cohort of patients treated with immune checkpoint inhibitors (ICI).
Methods |
We conducted a retrospective study among patients who received ICI from 07/27/2014 to 05/08/2020 at the medical oncology department of the Institut Paoli-Calmettes, Marseille, France. All medical files were systemically reviewed by a rheumatologist who collected clinical features, time of occurrence, treatment regimen, irAEs management, course and outcomes. We also assessed tumor response 3 months after introduction of ICI, according to severity and treatments used to manage musculoskeletal irAEs.
Results |
Among 927 patients treated with ICI for a solid tumor, 118 patients (12.7%) presented a musculoskeletal irAE. Their median age was 66.5, 61% were male, and they mainly had a lung (57.6%) or urological cancer (27.1%). The most frequently involved ICI was an anti PD-1. Arthralgias and myalgias were the most frequent musculoskeletal irAEs (9.8%) and inflammatory rheumatic features were reported in 36 patients (3.9%) with elevated acute phase reactants and negative immunological markers. The median time of onset was 2 months (IC 95% 1.8; 2.7). Tumor response at 3 months did not differ according to musculoskeletal irAE severity, type of manifestation (arthralgias/myalgias versus inflammatory rheumatic features), pain patterns (mechanical versus inflammatory) or irAE treatments.
Conclusion |
Musculoskeletal irAEs in this large cohort of patients treated with ICI were frequent (12.7%), mostly mild and well tolerated.
Le texte complet de cet article est disponible en PDF.Keywords : Immune checkpoint inhibitors, Musculoskeletal immune-related adverse events, Non-inflammatory musculoskeletal irAEs, Pre-existing chronic inflammatory rheumatic diseases, Systemic glucocorticoids, Tumor response
Abbreviations : ICI, IrAE(s), CTCAE, NSAIDS, csDMARD(s), bDMARD(s), DMARD(s), NA
Plan
Vol 90 - N° 1
Article 105457- janvier 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?