Musculoskeletal immune-related adverse events in 927 patients treated with immune checkpoint inhibitors for solid cancer - 15/01/23
, Emilie Fockens a, Patrick Sfumato b, Christophe Zemmour b, Anne Madroszyk c, Pierre Lafforgue a, Thao Pham aHighlights |
• | 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.
El texto completo de este artículo está 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
Esquema
Vol 90 - N° 1
Artículo 105457- janvier 2023 Regresar al número
Artículo precedente
- Prevalence, mortality, and treatment of patients with rheumatoid arthritis: A cohort study of the French National Health Data System, 2010–2019
- Laura Pina Vegas, Jérôme Drouin, Rosemary Dray-Spira, Alain Weill
- Interaction of TNFi and conventional synthetic DMARD in SARS-CoV-2 vaccine response in axial spondyloarthritis and psoriatic arthritis
- Carla G.S. Saad, Matheus S.R. Silva, Perceval D. Sampaio-Barros, Julio C.B. Moraes, Cláudia G. Schainberg, Celio R. Gonçalves, Andrea Y. Shimabuco, Nadia E. Aikawa, Emily F.N. Yuki, Sandra G. Pasoto, Leonard V.K. Kupa, Renato K. Aoyama, Carlo S.R. Araujo, Clóvis A. Silva, Ana C. Medeiros-Ribeiro, Eloisa Bonfa
Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
El acceso al texto completo de este artículo requiere una suscripción.
¿Ya suscrito a @@106933@@ revista ?