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Findings detail frequency of immune related adverse events associated with pembrolizumab
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WASHINGTON — Researchers found a higher adverse event rate than what was previously reported for patients who took pembrolizumab and noted a case of large-vessel vasculitis, according to an abstract presented at the American College of Rheumatology Annual Meeting.
Olga Pinkston, MD, rheumatologist at the Mayo Clinic in Jacksonville, Florida, and colleagues aimed to identify the type and frequency of immune-related adverse events in patients who took immune checkpoint inhibitors. To do this, researchers evaluated adverse events — grouped by organ system — in 74 patients who received pembrolizumab for melanoma at the Mayo Clinic in Jacksonville during a 2-year period. Of the 74 patients, 69 patients had advanced melanoma and were treated with at least one cycle of pembrolizumab and three patients consulted a rheumatologist. The researchers evaluated notes from the initial oncologic assessment, notes from follow-up, record of hospitalization or referral and record of treatment with glucocorticoids.
Researchers found one patient was hospitalized for recurrent diarrhea and was diagnosed with large-vessel vasculitis after a CT scan showed thickening of the abdominal aorta and ileum and ileal dilation, which suggested ischemia due to vasculitis of the superior mesenteric artery. Another patient had a history of Raynaud’s disease and was evaluated for hand pain with swelling. The patient was treated with prednisone before evaluation; however, there was still swelling and limited extension of the wrists bilaterally. In addition, one patient had a history of seronegative rheumatoid arthritis, was in remission, was no longer taking hydroxychloroquine and had no flare-ups while taking pembrolizumab.
In the 34 patients with musculoskeletal and connective tissue adverse events, 28 had arthralagia and 11 were treated with glucocortiocoids. In the 26 patients with skin and subcutaneous tissue events, 22 had pruritus and five were treated with glucocorticoids. In the 25 patients with gastrointestinal events, 12 had diarrhea and nine were treated with glucocorticoids. In the 13 patients with endocrine events, 12 had hypothyroidism and one had hypophysitis. – by Will Offit
Reference:
Pinkston O, et al. Abstract #1340. Presented at: American College of Rheumatology Annual Meeting; Nov. 11-16, 2016; Washington.
Disclosure: The researchers report no relevant financial disclosures.