Polymyalgia rheumatica-like syndrome from checkpoint inhibitor therapy: case series and systematic review of the literature
Identifieur interne : 000484 ( Pmc/Checkpoint ); précédent : 000483; suivant : 000485Polymyalgia 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
Affiliations:
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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>
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<subj-group subj-group-type="hwp-journal-coll"><subject>1506</subject>
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<series-title>Original article</series-title>
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<title-group><article-title>Polymyalgia rheumatica-like syndrome from checkpoint inhibitor therapy: case series and systematic review of the literature</article-title>
</title-group>
<contrib-group><contrib id="author-51319636" contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-8773-7739</contrib-id>
<name><surname>Calabrese</surname>
<given-names>Cassandra</given-names>
</name>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib id="author-50718541" contrib-type="author"><name><surname>Cappelli</surname>
<given-names>Laura C</given-names>
</name>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib id="author-62392306" contrib-type="author"><name><surname>Kostine</surname>
<given-names>Marie</given-names>
</name>
<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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<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib id="author-22407901" contrib-type="author" corresp="yes"><name><surname>Calabrese</surname>
<given-names>Leonard</given-names>
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<xref ref-type="aff" rid="aff1">1</xref>
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<aff id="aff1"><label>1</label>
<institution content-type="department">Rheumatic & Immunologic Disease</institution>
,<institution>Cleveland Clinic</institution>
,<addr-line content-type="city">Cleveland</addr-line>
,<addr-line content-type="state">Ohio</addr-line>
,<country>USA</country>
</aff>
<aff id="aff2"><label>2</label>
<institution content-type="department">Division of Rheumatology</institution>
,<institution>Johns Hopkins School of Medicine</institution>
,<addr-line content-type="city">Baltimore</addr-line>
,<addr-line content-type="state">Maryland</addr-line>
,<country>USA</country>
</aff>
<aff id="aff3"><label>3</label>
<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>
</corresp>
</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: <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/4.0/">http://creativecommons.org/licenses/by-nc/4.0/</ext-link>
.</license-p>
</license>
</permissions>
<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>
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