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Cited by 290

The DOI matches its Crossref record; 42 of the 42 references it cites were found in a registry or an index.

EULAR points to consider for the diagnosis and management of rheumatic immune-related adverse events due to cancer immunotherapy with checkpoint inhibitors

Open access
Kostine, Marie, Finckh, Axel, Bingham, Clifton O, Visser, Karen, Leipe, Jan, Schulze-Koops, Hendrik, Choy, Ernest H, Benesova, Karolina, Radstake, Timothy R D J, Cope, Andrew P, Lambotte, Olivier, Gottenberg, Jacques-Eric, Allenbach, Yves, Visser, Marianne, Rusthoven, Cindy, Thomasen, Lone, Jamal, Shahin, Marabelle, Aurélien, Larkin, James, Haanen, John B A G, Calabrese, Leonard H, Mariette, Xavier, Schaeverbeke, Thierry·2021·Annals of the Rheumatic Diseases
DOI 10.1136/annrheumdis-2020-217139
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Abstract

BACKGROUND: Rheumatic and musculoskeletal immune-related adverse events (irAEs) are observed in about 10% of patients with cancer receiving checkpoint inhibitors (CPIs). Given the recent emergence of these events and the lack of guidance for rheumatologists addressing them, a European League Against Rheumatism task force was convened to harmonise expert opinion regarding their identification and management. METHODS: First, the group formulated research questions for a systematic literature review. Then, based on literature and using a consensus procedure, 4 overarching principles and 10 points to consider were developed. RESULTS: The overarching principles defined the role of rheumatologists in the management of irAEs, highlighting the shared decision-making process between patients, oncologists and rheumatologists. The points to consider inform rheumatologists on the wide spectrum of musculoskeletal irAEs, not fulfilling usual classification criteria of rheumatic diseases, and their differential diagnoses. Early referral and facilitated access to rheumatologist are recommended, to document the target organ inflammation. Regarding therapeutic, three treatment escalations were defined: (1) local/systemic glucocorticoids if symptoms are not controlled by symptomatic treatment, then tapered to the lowest efficient dose, (2) conventional synthetic disease-modifying antirheumatic drugs, in case of inadequate response to glucocorticoids or for steroid sparing and (3) biological disease-modifying antirheumatic drugs, for severe or refractory irAEs. A warning has been made on severe myositis, a life-threatening situation, requiring high dose of glucocorticoids and close monitoring. For patients with pre-existing rheumatic disease, baseline immunosuppressive regimen should be kept at the lowest efficient dose before starting immunotherapies. CONCLUSION: These statements provide guidance on diagnosis and management of rheumatic irAEs and aim to support future international collaborations.

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Metadata

Authors
Kostine, M., Finckh, A., Bingham, C. O., Visser, K., Leipe, J., Schulze-Koops, H., Choy, E. H., Benesova, K., Radstake, T. R. D. J., Cope, A. P., Lambotte, O., Gottenberg, J.-E., Allenbach, Y., Visser, M., Rusthoven, C., Thomasen, L., Jamal, S., Marabelle, A., Larkin, J., Haanen, J. B. A. G., Calabrese, L. H., Mariette, X., & Schaeverbeke, T.
Venue
Annals of the Rheumatic Diseases
Publisher
Elsevier BV
Published
2021-01
Volume
80
Issue
1
Pages
36-48
ISSN
0003-4967 (ISSN-L)
DOI
10.1136/annrheumdis-2020-217139
OpenAlex
W3018517995
Cited by
290
References
42
FWCI
12.03
Type
journal article
Language
en
Open access
hybrid

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