[pubmed] Inflammatory myositis in cancer patients receiving immune checkpoint inhibitors

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Arthritis Rheumatol. 2020 Dec 1. doi: 10.1002/art.41604. Online ahead of print.

ABSTRACT

OBJECTIVE: To estimate the incidence of immune checkpoint inhibitor (ICI)-related myositis (ICI-myositis) in cancer patients receiving ICIs, and to report associated clinical manifestations, patterns of care and outcomes.

METHODS: We identified a retrospective cohort of patients receiving ICIs between 2016 and 2019 seen at The University of Texas MD Anderson Cancer Center. Cases of ICI-myositis were identified using International Classification of Disease codes and confirmed by reviewing medical records, and pathology, as available.

RESULTS: A total of 9,088 patients received an ICI; 36 (0.40%) patients were identified with ICI-myositis: 17 (47%) patients with ICI-myositis alone and 19 (53%) with overlap manifestations (5 with myocarditis, 5 with myasthenia gravis, 9 with both). Incidence of ICI-myositis was 0.31% in those receiving ICI monotherapy and 0.94% in those receiving combination ICI therapy (relative risk 3.1, 95% confidence interval, 1.5-6.1). Twenty-five (69%) patients received at least one additional therapy to corticosteroids: plasmapheresis in 17 (47%), intravenous immune globulin in 12 (33%) and biologics in 11 (31%). Patients with overlap conditions had worse outcomes than those with myositis alone, and 79% of them developed respiratory failure. Eight patients died from their ICI-myositis, all had overlap syndrome with myasthenia gravis or myocarditis (p

Source: https://pubmed.ncbi.nlm.nih.gov/3325854 ... 8&v=2.13.0