Checks and Balances in Autoimmune Vasculitis

Cadena, Rebeca Hid; Abdulahad, Wayel H.; Hospers, Geke A.P.; Wind, Thijs T.; Boots, Annemieke M. H.; Heeringa, Peter; Brouwer, Elisabeth

doi:10.3389/fimmu.2018.00315

Cited by 29 publications

(29 citation statements)

References 113 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The term "autoimmune vasculitis" has been used in the phase II study of ipilimumab [55]. Various forms of vasculitis affecting large vessels have been reported, and the corresponding diagnoses include GCA [33,56,57] or periaortitis [58]. Additionally, medium or small vessels can be affected, with cases of granulomatosis with polyangiitis (GPA) [59,60], eosinophilic granulomatosis with polyangiitis (EGPA) [61] and cryoglobulinemic vasculitis [62] having been reported.…”

Section: Vasculitismentioning

confidence: 99%

Rheumatic Manifestations in Patients Treated with Immune Checkpoint Inhibitors

Μελισσαρόπουλος

Klavdianou

Filippopoulou

et al. 2020

IJMS

View full text Add to dashboard Cite

Immune checkpoint inhibitors (ICIs) are monoclonal antibodies that activate the immune system, aiming at enhancing antitumor immunity. Their clinical efficacy is well-documented, but the side effects associated with their use are still under investigation. These drugs cause several immune-related adverse events (ir-AEs), some of which stand within the field of rheumatology. Herein, we present a literature review performed in an effort to evaluate all publicly available clinical data regarding rheumatic manifestations associated with ICIs. The most common musculoskeletal ir-AEs are inflammatory arthritis, polymyalgia rheumatica and myositis. Non-musculoskeletal rheumatic manifestations are less frequent, with the most prominent being sicca, vasculitides and sarcoidosis. Cases of systemic lupus erythematosus or scleroderma are extremely rare. The majority of musculoskeletal ir-AEs are of mild/moderate severity and can be managed with steroids with no need for ICI discontinuation. In severe cases, more intense immunosuppressive therapy and permanent ICI discontinuation may be employed. Oncologists should periodically screen patients receiving ICIs for new-onset inflammatory musculoskeletal complaints and seek a rheumatology consultation in cases of persisting symptoms.

show abstract

Section: Vasculitismentioning

confidence: 99%

Rheumatic Manifestations in Patients Treated with Immune Checkpoint Inhibitors

Μελισσαρόπουλος

Klavdianou

Filippopoulou

et al. 2020

IJMS

View full text Add to dashboard Cite

show abstract

“…121 , 123 , 124 Most cases resolved with discontinuation of ICI and high-dose corticosteroids between two and four days, while one case persisted with low-grade symptoms and worsened upon starting another ICI. 124 No larger trials existed to evaluate incidence of ICI-associated GCA.…”

Section: Resultsmentioning

confidence: 99%

<p>Neuro-ophthalmic Complications of Immune Checkpoint Inhibitors: A Systematic Review</p>

Yau

Mezey

et al. 2020

View full text Add to dashboard Cite

Objective Immune checkpoint inhibitors (ICIs) are novel cancer therapies that may be associated with immune-related adverse events (IRAEs) and come to the attention of neuro-ophthalmologists. This systematic review aims to synthesize the reported ICI-associated IRAEs relevant to neuro-ophthalmologists to help in the diagnosis and management of these conditions. Methods A systematic review of the literature indexed by MEDLINE, Embase, CENTRAL, and Web of Science databases was searched from inception to May 2020. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Primary studies on ICIs and neuro-ophthalmic complications were included. Outcomes included number of cases and incidence of neuro-ophthalmic IRAEs. Results Neuro-ophthalmic complications of ICIs occurred in 0.46% of patients undergoing ICI and may affect the afferent and efferent visual systems. Afferent complications include optic neuritis (12.8%), neuroretinitis (0.9%), and giant cell arteritis (3.7%). Efferent complications include myasthenia gravis (MG) (45.0%), thyroid-like eye disease (11.9%), orbital myositis (13.8%), general myositis with ptosis (7.3%), internuclear ophthalmoplegia (0.9%), opsoclonus-myoclonus-ataxia syndrome (0.9%), and oculomotor nerve palsy (0.9%). Pembrolizumab was the most common causative agent for neuro-ophthalmic complications (32.1%). Mortality was highest for MG (19.8%). Most patients (79.8%) experienced improvement or complete resolution of neuro-ophthalmic symptoms due to cessation of ICI and immunosuppression with systemic corticosteroids. Conclusion While incidence of neuro-ophthalmic IRAEs is low, clinicians involved in the care of cancer patients must be aware of their presentation to facilitate prompt recognition and management. Collaboration between oncology and neuro-ophthalmology teams is required to effectively manage patients and reduce morbidity and mortality.

show abstract

“…In this study, any grade treatment-related adverse events (TRAEs) for this combination therapy was 73% compared to 70% for nivolumab monotherapy. Other studies, however, have shown significantly higher TRAEs with the combination [ 53 , 54 ]. In a randomized phase II study, combination of tremelimumab (anti-CTLA-4) and durvalumab (anti-PD-L1) was tested in patients with metastatic refractory colorectal cancer [ 55 ].…”

Section: Types Of Immunotherapy: Their Combinations and Limitationmentioning

confidence: 91%

Immunotherapies and Combination Strategies for Immuno-Oncology

Barbari

Fontaine

Parajuli

et al. 2020

IJMS

View full text Add to dashboard Cite

The advent of novel immunotherapies in the treatment of cancers has dramatically changed the landscape of the oncology field. Recent developments in checkpoint inhibition therapies, tumor-infiltrating lymphocyte therapies, chimeric antigen receptor T cell therapies, and cancer vaccines have shown immense promise for significant advancements in cancer treatments. Immunotherapies act on distinct steps of immune response to augment the body’s natural ability to recognize, target, and destroy cancerous cells. Combination treatments with immunotherapies and other modalities intend to activate immune response, decrease immunosuppression, and target signaling and resistance pathways to offer a more durable, long-lasting treatment compared to traditional therapies and immunotherapies as monotherapies for cancers. This review aims to briefly describe the rationale, mechanisms of action, and clinical efficacy of common immunotherapies and highlight promising combination strategies currently approved or under clinical development. Additionally, we will discuss the benefits and limitations of these immunotherapy approaches as monotherapies as well as in combination with other treatments.

show abstract

Checks and Balances in Autoimmune Vasculitis

Cited by 29 publications

References 113 publications

Rheumatic Manifestations in Patients Treated with Immune Checkpoint Inhibitors

Rheumatic Manifestations in Patients Treated with Immune Checkpoint Inhibitors

<p>Neuro-ophthalmic Complications of Immune Checkpoint Inhibitors: A Systematic Review</p>

Immunotherapies and Combination Strategies for Immuno-Oncology

Contact Info

Product

Resources

About