Polymyalgia rheumatica-like syndrome from checkpoint inhibitor therapy: case series and systematic review of the literature
Identifieur interne : 000530 ( Main/Merge ); précédent : 000529; suivant : 000531Polymyalgia rheumatica-like syndrome from checkpoint inhibitor therapy: case series and systematic review of the literature
Auteurs : Cassandra Calabrese [États-Unis] ; Laura C. Cappelli [États-Unis] ; Marie Kostine [France] ; Elizabeth Kirchner [États-Unis] ; Tawnie Braaten [États-Unis] ; Leonard Calabrese [États-Unis]Source :
- RMD Open [ 2056-5933 ] ; 2019.
Abstract
To assess whether the polymyalgia rheumatica (PMR)-like syndrome reported as an immune related adverse event (irAE) from checkpoint inhibitor therapy is consistent with the 2012 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) provisional criteria for PMR.
The cases were derived from two sources. Group 1 represents reported cases from three contributing centres. Group 2 was derived from a systematic review of the literature searching for all cases reported as PMR or PMR-like illness associated with checkpoint inhibitor therapy. Cases were assessed for the quality of reporting and then analysed to determine whether they fulfilled the 2012 EULAR/ACR provisional criteria for PMR.
A total of 49 patients were included for analysis. Among the entire group, 37 (75%) were designated ‘complete’ indicating that they had sufficient data to reliably apply the 2012 EULAR/ACR criteria. 28 (75%) cases fulfilled complete criteria for PMR. A number of cases also demonstrated some clinical features unusual for idiopathic PMR.
This study suggests a high proportion of reported cases of checkpoint inhibitor-related PMR fulfil preliminary criteria for PMR, yet in one quarter clinical details were incomplete making verification problematic. Furthermore, in the absence of a gold standard for the diagnosis of PMR, the relationship of checkpoint inhibitor-related PMR to the idiopathic form remains unclear.
Url:
DOI: 10.1136/rmdopen-2019-000906
PubMed: 31168414
PubMed Central: 6525600
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PMC:6525600Le document en format XML
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<author><name sortKey="Calabrese, Cassandra" sort="Calabrese, Cassandra" uniqKey="Calabrese C" first="Cassandra" last="Calabrese">Cassandra Calabrese</name>
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<author><name sortKey="Cappelli, Laura C" sort="Cappelli, Laura C" uniqKey="Cappelli L" first="Laura C" last="Cappelli">Laura C. Cappelli</name>
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<author><name sortKey="Kostine, Marie" sort="Kostine, Marie" uniqKey="Kostine M" first="Marie" last="Kostine">Marie Kostine</name>
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<author><name sortKey="Cappelli, Laura C" sort="Cappelli, Laura C" uniqKey="Cappelli L" first="Laura C" last="Cappelli">Laura C. Cappelli</name>
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<front><div type="abstract" xml:lang="en"><sec><title>Objective</title>
<p>To assess whether the polymyalgia rheumatica (PMR)-like syndrome reported as an immune related adverse event (irAE) from checkpoint inhibitor therapy is consistent with the 2012 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) provisional criteria for PMR.</p>
</sec>
<sec><title>Methods</title>
<p>The cases were derived from two sources. Group 1 represents reported cases from three contributing centres. Group 2 was derived from a systematic review of the literature searching for all cases reported as PMR or PMR-like illness associated with checkpoint inhibitor therapy. Cases were assessed for the quality of reporting and then analysed to determine whether they fulfilled the 2012 EULAR/ACR provisional criteria for PMR.</p>
</sec>
<sec><title>Results</title>
<p>A total of 49 patients were included for analysis. Among the entire group, 37 (75%) were designated ‘complete’ indicating that they had sufficient data to reliably apply the 2012 EULAR/ACR criteria. 28 (75%) cases fulfilled complete criteria for PMR. A number of cases also demonstrated some clinical features unusual for idiopathic PMR.</p>
</sec>
<sec><title>Conclusion</title>
<p>This study suggests a high proportion of reported cases of checkpoint inhibitor-related PMR fulfil preliminary criteria for PMR, yet in one quarter clinical details were incomplete making verification problematic. Furthermore, in the absence of a gold standard for the diagnosis of PMR, the relationship of checkpoint inhibitor-related PMR to the idiopathic form remains unclear.</p>
</sec>
</div>
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