EULAR: Pay attention to adverse events related to rheumatic immunity

Although the concept of cancer immunotherapy is far from new, monoclonal antibodies against immune checkpoints or "checkpoint inhibitors" (CPIs) represent an increasing number of drugs, covering multiple tumor types and all stages of disease
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Drugs that target T cell cytotoxic T lymphocyte-associated protein 4 (CTLA-4) or programmed cell death (ligand) 1 (PD-1/PD-L1) co-inhibiting receptors mark a turning point in the success of immunotherapy

Immune- targeted T cell cytotoxic T lymphocyte-associated protein 4 (CTLA-4) or programmed cell death (ligand) 1 (PD-1/PD-L1) drugs that co-suppress the receptor mark the success of immunotherapy Turning point

Administer one anti-CTLA-4 (ipilimumab), three anti-PD-1 (nivolumab, pembrolizumab, and cimiprizumab) and three anti-PD-L1 (atezolizumab, avelumab) And durvalumab)

Method: First, the group formulated research questions for a systematic literature review
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Then, based on the literature and using consensus procedures, 4 general principles and 10 points to be considered were formulated

Method: consensus

Results: The general principles defined the role of rheumatologists in the management of irAE and emphasized the joint decision-making process between patients, oncologists, and rheumatologists
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Points to consider inform rheumatologists that a wide range of musculoskeletal irAEs do not meet the usual classification criteria for rheumatism and their differential diagnosis

Results: Diagnosis Regarding treatment, three treatment upgrades are defined: (1) (2) (3)

In summary, these considerations provide the basis for the European Anti-Rheumatism Alliance's consensus on the diagnosis and management of rheumatic and systemic irAEs.
These irAEs represent a new and rapidly expanding field
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This working group aims to raise awareness and assist rheumatologists to improve the diagnosis and management of irAE patients

These points considered provide the basis for the European Union Against Rheumatism Consensus on the diagnosis and management of rheumatic and systemic irAEs.

Many of these manifestations, whether frequent (arthritis, myositis, Sjogren’s syndrome) or abnormally reported (scleroderma, lupus), are also features of graft-versus-host disease

 

Original: Kostine M, Finckh A, Bingham CO, Visser K, Leipe J, Schulze-Koops H, Choy EH, Benesova K, Radstake TRDJ, Cope AP, Lambotte O, Gottenberg JE, Allenbach Y, Visser M, Rusthoven C, Thomasen L, Jamal S, Marabelle A, Larkin J, Haanen JBAG, Calabrese LH, Mariette X, Schaeverbeke T.

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