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Ipilimumab, nivolumab linked with increased risk of autoimmune joint, tissue diseases in cancer patients
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Patients with cancer treated with ipilimumab or nivolumab alone or in combination with each other experienced a higher than normal risk of developing autoimmune joint and tissue diseases, according to results recently published in Annals of Rheumatic Diseases.
From 2012 to 2016, researchers identified 13 adult patients (83% men) with cancer being treated with ipilimumab or nivolumab as monotherapy or combination for solid tumors reporting new rheumatological symptoms. Cancer types included melanoma, non-small cell lung cancer, small cell lung cancer and renal cell carcinoma, according to results.
Laura C. Cappelli
Inflammatory arthritis developed in nine patients, results showed, with synovitis confirmed in four patients on imaging and in four patients with the use of inflammatory synovial fluid. Researchers noted sicca syndrome with severe salivary hypofunction developed in four patients. Other immune-related adverse events included pneumonitis, colitis, interstitial nephritis and thyroiditis, according to results. Overall, results showed five patients had positive antinuclear antibodies. Researchers found varying responses with corticosteroid treatment among the 13 patients, and two patients with inflammatory arthritis were treated with methotrexate and antitumor necrosis factor therapy.
“Immune checkpoint inhibitors used to treat cancer can lead to adverse events resembling classic rheumatologic diseases,” study coauthor Laura C. Cappelli, MD, of Johns Hopkins University School of Medicine, told Healio.com/Rheumatology. “Rheumatologists should be aware of this phenomenon and that symptoms can be severe and persistent, requiring longitudinal management.” – by Casey Tingle
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Disclosures: Cappelli reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.
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