Posterior Uveitis Associated with Cemiplimab

Dow, Eliot; Hou, Kirk; Ransome, Susan S.; Abbassi, Sam; Tsui, Edmund

doi:10.1080/09273948.2021.1872649

Ocular Immunology and Inflammation

2021

DOI: 10.1080/09273948.2021.1872649

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Posterior Uveitis Associated with Cemiplimab

Eliot Dow¹,

Kirk Hou²,

Susan S. Ransome³

et al.

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Cited by 5 publications

(1 citation statement)

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“…Given cemiplimab’s recent Food and Drug Administration approval, reported cases of uveitis associated with treatment are rare to date. A case of posterior uveitis with retinal vasculitis was successfully treated by discontinuing cemiplimab as well as initiating local and systemic steroids 3 . Here, we describe a case of a patient with squamous cell carcinoma treated with cemiplimab who developed VKH-like syndrome that was managed successfully with adalimumab (ADA).…”

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confidence: 99%

Vogt-Koyanagi-Harada-like Syndrome Induced by Checkpoint Inhibitor Cemiplimab

Huang

Khan

Saraiya

et al. 2023

Journal of Immunotherapy

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Checkpoint inhibition targeting programmed cell-death protein 1 has demonstrated efficacy for a wide range of indications including cutaneous malignancy. However, immune-related adverse events (irAEs), including infrequent but visually impactful ocular irAEs, require careful consideration of treatment options, including medication withdrawal, local corticosteroids, or rarely immunomodulation. This case presents a 53-year-old woman who developed uveitis and mucous membrane ulcers after treatment for numerous cutaneous neoplasms, primarily squamous cell carcinoma, with the programmed cell-death protein 1 inhibitor cemiplimab. Ophthalmic examination revealed diffuse choroidal depigmentation consistent with a Vogt-Koyanagi-Harada-like syndrome. Topical and periocular steroids were used to treat the intraocular inflammation, and cemiplimab was discontinued. Because of ongoing severe uveitis, systemic corticosteroids and corticosteroid-sparing immunosuppression were initiated. Specifically, azathioprine and methotrexate were introduced, but each was stopped due to side effects, prompting the initiation of adalimumab (ADA) treatment. While ADA controlled intraocular inflammation, the squamous cell carcinomas were noted to progress, resulting in the discontinuation of ADA. However, a uveitis recurrence was observed. After a discussion of risks and benefits of biologic immunosuppressive therapy, including the risk of vision loss, ADA was restarted with successful disease quiescence at a 16-month follow-up. The cutaneous neoplasms were managed with topical and intralesional therapies, such as 5-fluorouracil. Recent dermatologic examinations suggested no new cutaneous lesions. This scenario presents the effective use of ADA in an ocular irAE that balances the management of sightthreatening ocular inflammation with the risk of promoting recurrent or de novo neoplastic disease.

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mentioning

confidence: 99%

Vogt-Koyanagi-Harada-like Syndrome Induced by Checkpoint Inhibitor Cemiplimab

Huang

Khan

Saraiya

et al. 2023

Journal of Immunotherapy

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Update on Immune Checkpoint Inhibitor-Associated Uveitis

Kim

Paul

Echegaray

2023

Curr Ophthalmol Rep

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Cemiplimab

2023

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Posterior Uveitis Associated with Cemiplimab

Cited by 5 publications

References 11 publications

Vogt-Koyanagi-Harada-like Syndrome Induced by Checkpoint Inhibitor Cemiplimab

Vogt-Koyanagi-Harada-like Syndrome Induced by Checkpoint Inhibitor Cemiplimab

Update on Immune Checkpoint Inhibitor-Associated Uveitis

Cemiplimab

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