التفاصيل البيبلوغرافية
| العنوان: |
Inflammatory arthritis and sicca syndrome induced by nivolumab and ipilimumab. |
| المؤلفون: |
Calabrese, Leonard, Velcheti, Vamsidhar, Cappelli, Laura C, Gutierrez, Anna Kristina, Baer, Alan N, Albayda, Jemima, Manno, Rebecca L, Haque, Uzma, Lipson, Evan J, Bleich, Karen B, Shah, Ami A, Naidoo, Jarushka, Brahmer, Julie R, Le, Dung, Bingham, Clifton O 3rd |
| المصدر: |
Annals of the Rheumatic Diseases; Jan2017, Vol. 76 Issue 1, p1-3, 3p, 1 Diagram |
| مصطلحات موضوعية: |
DRUG therapy for arthritis, ANTINEOPLASTIC agents, ARTHRITIS, AUTOANTIBODIES, MONOCLONAL antibodies, RESEARCH funding, SJOGREN'S syndrome, SYNOVITIS |
| مستخلص: |
Objectives: Immune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1) pathways have demonstrated survival improvements in multiple advanced cancers, but also cause immune-related adverse events (IRAEs). IRAEs with clinical features similar to rheumatic diseases have not been well described. We report patients with inflammatory arthritis and sicca syndrome secondary to ICIs.Methods: We report patients evaluated in the Johns Hopkins Rheumatology clinics from 2012 to 2016 identified as having new rheumatological symptoms in the context of treatment with ipilimumab (anti-CTLA-4) and/or nivolumab (anti-PD-1) for solid tumours.Results: We identified 13 patients who received ICIs and developed rheumatological IRAEs. Mean age was 58.7 years. Cancer types included melanoma, non-small cell lung cancer, small cell lung cancer and renal cell carcinoma. ICI regimens included nivolumab or ipilimumab as monotherapy (n=5), or combination nivolumab and ipilimumab (n=8). Nine of 13 patients developed an inflammatory arthritis, 4 with synovitis confirmed on imaging (3 ultrasound, 1 MRI) and 4 with inflammatory synovial fluid. Four patients developed sicca syndrome with severe salivary hypofunction. Other IRAEs included: pneumonitis, colitis, interstitial nephritis and thyroiditis. Antinuclear antibodies were positive in 5 out of 13 patients. All 13 patients were treated with corticosteroids with varying response. Two patients were treated with methotrexate and antitumor necrosis factor therapy for inflammatory arthritis.Conclusions: As ICIs are increasingly used for a range of malignancies, new cases of rheumatic IRAEs are likely to emerge. Further research is required to understand mechanisms, determine risk factors and develop management algorithms for rheumatic IRAEs. [ABSTRACT FROM AUTHOR] |
|
Copyright of Annals of the Rheumatic Diseases is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
