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Polymyalgia rheumatica-like syndrome from checkpoint inhibitor therapy: case series and systematic review of the literature

Identifieur interne : 000674 ( Ncbi/Merge ); précédent : 000673; suivant : 000675

Polymyalgia 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 :

RBID : PMC:6525600

Abstract

Objective

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.

Methods

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.

Results

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.

Conclusion

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:6525600

Le document en format XML

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<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>
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<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>
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<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>
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<name>
<surname>Calabrese</surname>
<given-names>Cassandra</given-names>
</name>
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<name>
<surname>Cappelli</surname>
<given-names>Laura C</given-names>
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<name>
<surname>Kostine</surname>
<given-names>Marie</given-names>
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<xref ref-type="aff" rid="aff3">3</xref>
</contrib>
<contrib id="author-52246950" contrib-type="author">
<name>
<surname>Kirchner</surname>
<given-names>Elizabeth</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
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<contrib id="author-67531706" contrib-type="author">
<name>
<surname>Braaten</surname>
<given-names>Tawnie</given-names>
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<institution>Cleveland Clinic</institution>
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<addr-line content-type="city">Cleveland</addr-line>
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<addr-line content-type="state">Ohio</addr-line>
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<country>USA</country>
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<aff id="aff2">
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<institution content-type="department">Division of Rheumatology</institution>
,
<institution>Johns Hopkins School of Medicine</institution>
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<addr-line content-type="city">Baltimore</addr-line>
,
<addr-line content-type="state">Maryland</addr-line>
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<country>USA</country>
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<institution content-type="department">Rheumatology Department</institution>
,
<institution>Centre Hospitalier Universitaire de Bordeaux</institution>
,
<addr-line content-type="city">Bordeaux</addr-line>
,
<country>France</country>
</aff>
<author-notes>
<corresp>
<label>Correspondence to</label>
Dr Leonard Calabrese;
<email>calabrl@ccf.org</email>
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</author-notes>
<pub-date pub-type="collection">
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>25</day>
<month>4</month>
<year>2019</year>
</pub-date>
<volume>5</volume>
<issue>1</issue>
<elocation-id>e000906</elocation-id>
<history>
<date date-type="received">
<day>14</day>
<month>1</month>
<year>2019</year>
</date>
<date date-type="rev-recd">
<day>12</day>
<month>3</month>
<year>2019</year>
</date>
<date date-type="accepted">
<day>27</day>
<month>3</month>
<year>2019</year>
</date>
</history>
<permissions>
<copyright-statement>© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</copyright-statement>
<copyright-year>2019</copyright-year>
<license license-type="open-access">
<license-p>This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:
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<self-uri xlink:title="pdf" xlink:href="rmdopen-2019-000906.pdf"></self-uri>
<abstract>
<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>
</abstract>
<kwd-group>
<kwd>polymyalgia rheumatica</kwd>
<kwd>inflammation</kwd>
<kwd>autoimmune diseases</kwd>
</kwd-group>
<custom-meta-group>
<custom-meta>
<meta-name>special-feature</meta-name>
<meta-value>unlocked</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
</pmc>
<affiliations>
<list>
<country>
<li>France</li>
<li>États-Unis</li>
</country>
</list>
<tree>
<country name="États-Unis">
<noRegion>
<name sortKey="Calabrese, Cassandra" sort="Calabrese, Cassandra" uniqKey="Calabrese C" first="Cassandra" last="Calabrese">Cassandra Calabrese</name>
</noRegion>
<name sortKey="Braaten, Tawnie" sort="Braaten, Tawnie" uniqKey="Braaten T" first="Tawnie" last="Braaten">Tawnie Braaten</name>
<name sortKey="Calabrese, Leonard" sort="Calabrese, Leonard" uniqKey="Calabrese L" first="Leonard" last="Calabrese">Leonard Calabrese</name>
<name sortKey="Cappelli, Laura C" sort="Cappelli, Laura C" uniqKey="Cappelli L" first="Laura C" last="Cappelli">Laura C. Cappelli</name>
<name sortKey="Kirchner, Elizabeth" sort="Kirchner, Elizabeth" uniqKey="Kirchner E" first="Elizabeth" last="Kirchner">Elizabeth Kirchner</name>
</country>
<country name="France">
<noRegion>
<name sortKey="Kostine, Marie" sort="Kostine, Marie" uniqKey="Kostine M" first="Marie" last="Kostine">Marie Kostine</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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